National Health Insurance

Outlines the objectives of national health insurance, discusses the critical issues involved in assessing the various plans that have been proposed, and appraises the three main types of plans. Plan types include (1) the "catastrophic" approach, coverage requiring a high deductible and intended only to prevent financial devastation due to the cost of medical care, (2) "intermediate" approach, covering more than disastrous illnesses and requiring less out-of-pocket payment, and (3) full coverage of all medical-care expenses. None of the approaches is likely to substantially improve the nation's health. All provide financial protection against catastrophic illnesses; all redistribute income from the healthy to the sick, in different degrees; all can make the medical-care system more efficient. A fundamental choice must be made about whether efficiency is best promoted by market incentives — leaving the administration of national insurance in private hands — or by centralization in the public sector.