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March 14, 2007

Universal Health Care CoverageA Potential Hybrid Solution

Author Affiliations

Author Affiliation: Institute for Health Policy Studies, University of California, San Francisco.

JAMA. 2007;297(10):1115-1118. doi:10.1001/jama.297.10.1115

The United States spends a greater share of its gross domestic product on health care than other nations, yet more than 15.9% of its population lacks health insurance coverage.1 The US health measures are no better (and are often worse) than those of other nations.2 This combined inequity and inefficiency creates a moral imperative and opportunity for change. Some argue for a single-payer system, others for more reliance on the market and insurance subsidies. Apart from causing political gridlock, neither strategy would effectively both guarantee coverage and constrain costs. A hybrid approach combining universal risk pools, mandated coverage with income-based subsidies, and a restructured payment mechanism has the potential to improve both equity and efficiency.

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