Abstract

For much of the last year and a half, the US has appeared on the verge of extensively reforming its financing and provision of health care, guaranteeing universal coverage for basic care and significantly controlling the long-term growth of costs. But it now appears that with a new Republican-led Congress we will at best adopt only selected insurance reforms: guaranteeing portability of insurance between jobs, banning insurers from excluding preexisting conditions from a person's coverage, and perhaps increasing subsidies for the purchase of insurance by low-income families and small businesses. The long struggle throughout this century for a societal sharing of the financial burdens of illness will again have yielded only a small increment.