ABSTRACT
This chapter discusses a selective review of health care financing reforms in the United States and examines an explication of nonfinancial barriers to effective health care. It explores a delineation of the range of interim policy interventions required to lower the barriers to access. The reasons that universal coverage will not necessarily guarantee effective services to all are embedded in the nature and characteristics of the health care system. The first large-scale governmental reform of the US health care system in the post-World War II era involved the radical restructuring of the medical services of the Veterans Administration, renamed the Department of Veteran Affairs. Medicare currently assists hospitals that provide a large volume of un-compensated care through disproportionate share adjustments, special reimbursements for sole-service hospitals, and recently increased reimbursements for rural hospitals. Medical care characteristically requires an interaction between the patient seeking care and the physician or other caregiver.
