National health insurance and the problems of American medicine.
The problems of inequitable access to care, health care inflation, and reduced physician autonomy confront physicians and health care reformers with a dilemma. Piecemeal measures attempting to alleviate one problem in isolation simply exacerbate the others. A logical approach to addressing these problems together is a national health program based on a single payer of health services. By reducing administrative waste and emphasizing global budgetary strategies, the single-payer system could promote more efficient health care spending. While single-payer systems create more explicit political conflict over resource allocation, they also have demonstrated an ability to maintain quality of care and reduce bureaucratic intrusions into clinical practice.
Bodenheimer
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Department of Family and Community Medicine, University of California, San Francisco.
Grumbach
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D002170:Canada; D003363:Cost Control / Q000639:trends; D004470:Economics, Medical / Q000639:trends*; D006292:Health Priorities / Q000191:economics; D007250:Inflation, Economic / Q000639:trends; D009310:National Health Insurance, United States / Q000639:trends*; D014481:United States