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Previous Volume 328:1643-1644 June 3, 1993 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: On behalf of the National Leadership Coalition for Health Care Reform, Simmons et al. (Nov. 19 issue)¹ call for a new payroll tax to fund their national health insurance scheme. They fail, however, to note the many drawbacks and limitations of this approach, more commonly known as pay-or-play.

First, as with all payroll taxes, pay-or-play is fundamentally regressive and thus, to many, unfair. It would result in both high- and low-wage earners paying the same tax rates for health care.

Second, pay-or-play mandates higher costs to employers in the form of either health insurance premiums or taxes. . . . [Full Text of this Article]

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