Wednesday, May 24, 2017

Principles for Universal Health

Insurance for the United States



  1. True universality. Everybody in, nobody out, with one risk pool. No more “cherry-picking,” or exclusion of high-risk people from coverage.
  1. Tax-based financing, like Medicare, in accordance with income, instead of premiums, deductibles, and co-pays. Not free care, since everyone pays into the system through taxes.
  1. Full choice of providers in a delivery system that remains a mixture of private and public. Not socialized medicine, but national health insurance in the same way that Medicare is a national insurance program.
  1. Elimination of the odd link between employers and health insurance coverage.
  1. Coverage for all necessary services, including inpatient and outpatient care,emergency care, long-term care, mental health, treatment for substances, prescriptions, and basic dental and eye care with no discrimination by type of illness or ability to pay.
  1. True integration of public health and preventive services with adequate funding, both on a personal and community basis.
  1. Continued funding for special services necessary to serve special population groups: e.g., immigrants, migrant farm workers and the disabled.
  1. The practice of medicine based on scientific principles.
  1. A national trust fund dedicated specifically to health care.
  1. National planning that allows a large degree of local autonomy. A national health board with regional or state-by-state equivalents.
  1. Public accountability. Eliminates the “opaque” (hard to fathom) financing practices of the current system.
  1. Global budgeting, which entails setting priorities, but is flexible enough to support medical education, research and excellence in medicine.
  1. Simplified administration with greatly reduced administrative costs, leaving 90-95percent of health care funds for patient care, prevention and research.
  1. Reasonable and equitable reimbursement for health care providers.
  1. Insurance companies would be allowed to sell policies only for uncovered services.
  1. Treatment of health as a “public good” instead of as a market commodity.


  Bob LeBow, MD, MPH. (2002). Health care meltdown: Confronting the myths and fixing our failing system. Boise, ID:JRI Press, pp.9-10.

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