Some Perspectives Concerning Federal Health Legislation

In response to growing public concern about the cost, availability, and accessibility of personal health services, the Congress is almost certain to enact a rather broad national health insurance plan within the next several years. The important features of the debate leading to enactment of national health insurance will involve the issues of comprehensiveness of insurance coverage and private vs public financing mechanisms. Advocates of a public financing mechanism contend that the private, voluntary health insurance sector is incapable of providing equitable, comprehensive health insurance benefits. They believe that it is only through a comprehensive public financing mechanism that true public accountability can be achieved. Growing concern is being generated within the Congress by the inability of elected and appointed officials, charged with the responsibility for administering publicly financed but partial health insurance programs (eg, Medicare, Medicaid), to control costs and utilization of services.

In addition to the passage of