ABSTRACT

This chapter discusses a more promising alternative, one that builds upon our own experiences in related areas of societal reforms, particularly employment, housing, and education, which may help us to obtain a deeper understanding about the dilemmas we face in improving the United States health care financing and delivery system. The daily press is a potent reminder that for a number of years the United States has been engaged in fruitless discussions about how to reform its health care system, discussions that are likely to continue for some time to come. In 1977 when Alain Enthoven submitted the draft of his plan, the United States spent $170 billion for national health care. Unlike employment or housing, which the individual is expected to obtain through his or her own efforts, public education has been a governmentally mandated, long-established service available to everybody between the ages of six and eighteen, and, selectively, for children as young as three and four.