ABSTRACT
The United States actually has several health systems, one for indigent war veterans, for those on welfare and the medically indigent, for the aged, and for middle- and high-income employees. Capitation payment and delivery systems, referred to as Health Maintenance Organizations, have increased to where they represent 15% of the insured population. The most popular form of delivery system is "managed care." In the mid-1960s, the major emphasis of health policy was on redistribution: increased government expenditures on the poor and aged. The structure of the health care industry in the past was not determined solely by economies of scale. Legal and financing issues also determined the structure of this industry. As medical expenditures continue to increase rapidly throughout the 1980s, large businesses became dissatisfied with market competition. Many business executives are now calling for "national health insurance" as a means of limiting expenditures.
