[NEED FOR DENTAL CARE IN ARMED SERVICES AS PART OF A TOTAL NATIONAL HEALTH PROGRAM].
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Growing gaps in health insurance coverage have generated increased interest in enactment of major reforms. A framework for evaluating proposals embodying different approaches to a national health program is offered, highlighting seven dimensions: inclusiveness of coverage; comprehensiveness of benefits; financing methods; efficiency of resource utilization; extent of planning and market forces in resource allocation; accountability to beneficiaries; and political feasibility. Four health care reform bills in the Congress are shown either to emphasize political feasibility at the expense or universal coverage and comprehensive benefits, or to stress coverage, benefits, and system reform at the cost of such feasibility.
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In this position paper we outline the major problems that exist in the U.S. health care system and present a proposal for addressing them. This paper contains the major health proposal put forward by the Jesse Jackson 1988 Campaign, calling for the establishment in the United States of a universal and comprehensive National Health Program (NHP) that will be federally funded and administered and be equitably financed. We also discuss how the NHP will affect patients, unions, corporations and employers, practitioners and other health workers, hospitals, and the insurance industry. Specific proposals are made for the transition from the current system to the proposed NHP, with a discussion of the major differences between national health proposals put forward by the two major Democratic contenders for the U.S. Presidency. This position paper also includes a brief appendix sketching some of the major differences between the U.S. and the Canadian medical care systems.
Tracing the complex changes that have taken place in the nation's health-care system over the last eight years, Geiger points out why opportunities are now ripe for change. If progress is to be made towards establishing a national health-care program, he argues, we must shift the terms of the debate away from fiscal and technical details and return it to the arena of public concern and social responsibility.
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