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Previous Volume 352:1255-1260 March 24, 2005 Number 12 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.

	Full Text PDF PDA Full Text Purchase this article Editorial by Kronick, R. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

Dissatisfaction with the financing of U.S. health care is widespread. The system is inefficient, inequitable, and increasingly perceived to be unaffordable.^1,2,3,4 Because only incremental reform is deemed politically feasible, inordinate attention is devoted to treating the institutional symptoms rather than diagnosing systemic problems that require major surgery. As an alternative, we propose a voucher system for universal health care, an efficient, fair, and relatively simple approach that might elicit broad support. We recognize that change is not imminent, but such a proposal can stimulate discussion and provide a readily available model when the political climate becomes hospitable for endorsing meaningful . . . [Full Text of this Article]

Flaws in the Current Health Care Financing System

Features of the Voucher System

Universality

Free Choice of Health Plan

Freedom to Purchase Additional Services

Funding by an Earmarked Value-Added Tax

Reliance on a Private Delivery System

End of Employer-Based Insurance

Elimination of Medicaid and Other Means-Tested Programs

Phasing Out of Medicare

Administration

Assessment of Technology and Outcomes

Universal Benefits Package

Economic Feasibility

Political Feasibility

Issues Requiring Additional Study

Source Information

From the Posterity Project, Chicago (E.J.E.); and the Department of Economics, Stanford University, Stanford, Calif. (V.R.F.).

Related Letters:

A Proposal for Universal Coverage
Relman A. S., Hinkel J. M., Emanuel E. J., Fuchs V. R.
Extract | Full Text | PDF  
N Engl J Med 2005; 353:96-97, Jul 7, 2005. Correspondence

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