Journal Article

Political Accommodations in Multipayer Health Care Systems: Implications for the United States

Tuohy, Carolyn Hughes

2019

Overview

Current interest in a single-payer approach to universal health care coverage in the United States has also triggered interest in alternative multipayer approaches to the same goal. An analysis of experiences in Germany, the Netherlands, Switzerland, and Israel shows how the founding of each system required a distinctive political settlement and how the subsequent timing, content, and course of the reforms were shaped by political circumstances and adjustments to the founding bargain in each nation. Although none of these systems is directly transferable to the United States, certain parallels with the American context suggest that a multipayer approach might offer a model for universal coverage that is more politically feasible than a single-payer scheme but also that issues associated with risk selection and other potential inequities would remain.

• Publisher: American Public Health Association
• Subject: 19th century / 20th century / AJPH Financing Health Care / Employers / Europe / Founding / Health care / Health care policy / Health Financing / Health insurance / Health Policy / Health Reform / Health services / History, 19th Century / History, 20th Century / History, 21st Century / Humans / Income distribution / Inequality / Insurance coverage / Insurance, Health - history / Insurance, Health - legislation & jurisprudence / Insurance, Health - organization & administration / Israel / National health insurance / Nazi era / Political change / Politics / Population / Postwar reconstruction / Public health / Reforms / Settlements & damages / Single-Payer System - organization & administration / Social Security - history / State regulation / United States / Universal Health Insurance - history / Universal Health Insurance - organization & administration / Workers / World War II