ABSTRACT
This chapter examines the important issues to health system reform and suggests that the incidence of health premiums under employer-based systems falls on workers. It explains the group reforms by their two main motivations: the desire to see that people get needed health care, and the desire to control the rising cost of health care. Most would agree that a national health system reform must address the elements: A health "safety net" for all residents, irrespective of age, health, or employment status. The United States established a more comprehensive health care system in 2010 with the Affordable Care Act, but many issues remain. The most challenging issue is to determine whether health reform will build largely on the existing framework of government programs and private employment-based insurance with most of the reform effort aimed at cost containment and reducing the pool of uninsured. National health insurance programs that guarantee universal coverage certainly cost a great deal of money.
