Single-source financing systems. A solution for the United States?
Although tax-based and social insurance-based forms of single-source financing differ in how they raise funds, they share a common set of structural characteristics. In particular, they both enable publicly accountable authorities to control aggregate expenditure levels by creating a countervailing power to pressures for increased expenditures from providers. While major reform initiatives are under way in European single-source financing systems, these initiatives have so far sought to improve the efficiency, effectiveness, and/or responsiveness to patterns of service delivery without reducing their commitment to universal access to necessary care. The article concludes with a review of the advantages and disadvantages that could accompany the introduction of a single-source financing system in the United States.
Saltman
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Division of Health Policy and Management, Emory University School of Public Health, Atlanta, Ga. 30329.
D002170:Canada; D005060:Europe; D035082:Federal Government; D038622:Internationality; D017057:Medically Uninsured; D009310:National Health Insurance, United States; D009313:National Health Programs / Q000458:organization & administration*; D012941:Social Responsibility; D012943:Social Security / Q000458:organization & administration; D013660:Taxes; D014481:United States