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I. S. Falk
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Current interest in the development of a national health insurance in the United States invites a clear determination of objectives through identification of the problems to be resolved by a new program and an understanding of how these problems came about and why. Historical review of the background and the evolution of the current medical care scene provides perspective. Critical review may also contribute to better design of what should be intended by new undertakings and to utilization of lessons from the past in order that the specifications should minimize mistakes for the future. Here, therefore, is a review of major events and the lessons they taught (or should have taught), from the Final Report of the Committee on the Costs of Medical Care (1932) to Medicare and Medicaid (1965) and their early operational years through 1972. It is a personal review but by an author who was privileged to be a participant in many of the studies and legislative campaigns as well as a continuous observer of the evolving scene. This historical review was planned as prologue to a course of action. The author therefore comments on various current legislative proposals and indicates why he and others advocate the Health Security Bill – principally because its scope embraces not only the financing of comprehensive personal health services for the whole population but, equally and simultaneously, the improvement of the medical care system as well. This review and the presentation of a rationale for action are timely, since diverse and conflicting proposals are now engaging national attention and are being debated in the Congress.
Author(s): I. S. Falk
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Volume 51, Issue 1 (pages 1–32) Published in 1973
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.