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January 18, 1995

What to Do Now on Health Care System Reform

Author Affiliations

From the Heritage Foundation, Washington, DC.

JAMA. 1995;273(3):253-254. doi:10.1001/jama.1995.03520270089046

America can in 1995 take the right steps needed to reform the health care system if policymakers recognize that for the vast majority of working Americans, security was and remains a central issue—the fear that health care services they are comfortable with today will not be there in the future.

It is crucial to understand that this insecurity is in part inherent in the employer-provided insurance system, although other factors do contribute to insecurity. Americans typically choose and own their life insurance, their home, and their car, and their place of employment is irrelevant to the choices available. With this ownership comes control and security. But in health care, the employer typically owns their policy, deciding which major services will be covered and, increasingly, who will provide them. The employer's overriding concern of curbing cost typically conflicts with the employee's concern of access to certain services and physicians and simplicity

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