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Books, Journals, New Media
May 25, 2005

Health Systems

Author Affiliations

Books, Journals, New Media Section Editor: Harriet S. Meyer, MD, Contributing Editor, JAMA; Journal Review Editor: Brenda L. Seago, MLS, MA, Medical College of Virginia Campus, Virginia Commonwealth University.

JAMA. 2005;293(20):2537-2541. doi:10.1001/jama.293.20.2538

Every fall the Census Bureau announces the latest data on uninsured persons in the United States—usually a million or two more than the year before. We’ve been watching these announcements for 25 years, long enough to see the number of uninsured nearly double. Most years, politicians respond that the “crisis” demands urgent action.

These ritual pronouncements are part of the strange dance of US health policy. Virtually all agree that our health insurance system is broken and getting worse. Yet reform proposals from both political parties are ever feebler. Where once President Nixon called for universal coverage through a mandate requiring employers to pay for insurance, today President Bush offers tax credits that would cover perhaps 5 million of the uninsured. Where President Truman and his successors fought for national health insurance, Senator Kerry hoped to cut the number of uninsured to 17 million by expanding Medicaid and offering subsidies for private insurance.