ABSTRACT
Proponents of universal health insurance, especially of the Canadian variety, like to seize upon selective results of public opinion polls to bolster their political case. The first and firmest limiting fact is that the country is far from ready to enact a single, government-directed, national health insurance plan—one that would be totally tax-financed, eliminating both employer sponsorship and private insurance. From a wishful-thinking perspective, a health care program intended to assure access should include all services that might be beneficial, from prenatal and preventive to acute and chronic, and should include those requiring long-term care in nursing homes. Combining state and local public health department services with public insurance clinics like community health centers, tying preventive health programs into public-school operations, and pioneering broader use of physician assistants and nurse practitioners to strengthen rural health care accessibility are among the thrusts that might be developed aggressively.
