An American approach to health system reform.

ABSTRACT

KIE: To meet the need for expanded health care coverage in America, Holahan, et al. of the Urban Institute, incorporate aspects of the Canadian health care system and the Pepper Commission's proposals in the design of what they propose as a cost effective and politically acceptable health care reform package. Medicare would be unchanged. Employers would provide basic coverage for their workers, or pay a tax in support of state-administrated public health insurance programs. This public program would replace Medicaid, and would be utilized by three groups: those whose employers opted to pay a tax, the poor, and citizens who buy into the program. Strong incentives for states to control health care costs would be provided by requiring states to bear the burden of cost increases exceeding the rate of growth in GNP.