[Skip to Content]
[Skip to Content Landing]
May 18, 1994

The United States Needs a Health System Like Other Countries

Author Affiliations

University of Cincinnati Medical Center Cincinnati, Ohio

JAMA. 1994;271(19):1482. doi:10.1001/jama.1994.03510430032021

To the Editor.  —The article by Dr Glaser1 on health system reform was remarkably lucid and thoughtful. I would like to add two comments. First, I believe that Glaser's concept is quite compatible with a single-payer model. Universal social insurance does not need to be the treasury (as it is in Canada). On the other hand, I see no advantage in a multiplicity of social insurances if we agree that classical market dynamics are not relevant to the problem. I am aware that in Germany, for instance, there are multiple sickness funds for historical reasons. Working in that system for 2 years as a primary care physician was fine, but having to use different prescription forms depending on the kind of sickness fund responsible for the patient was time-consuming and inconvenient. That inconvenience is not matched by any noticeable advantage to patient, provider, or any other component of the

First Page Preview View Large
First page PDF preview
First page PDF preview