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Published at www.nejm.org November 4, 2009 (10.1056/NEJMopv0909476)

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The health care reform effort in the United States is driven by the desires for cost control and expanded coverage. However, as Daniel Callahan recently wrote, "cost controls that are likely to be politically acceptable will not be very effective, and what might be effective will not be acceptable."¹ Unlike cost savings, which are often elusive, cost increases resulting from coverage expansion are always a reality. Proponents of universal coverage tend to point to the health care systems of other industrialized countries, especially Canada's, as alternative models. We would argue that the adoption of an approach focused on expanded coverage . . . [Full Text of this Article]

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