Medical Care for the Poor: No Magic Bullets

Abstract

LESS than a quarter of a century ago, at the time of the Great Society programs of President Lyndon Johnson, many believed that with the passage of Medicare and Medicaid a single standard of superior medical care for all Americans was at hand. Governmentally funded entitlement for the elderly and the poor, the two major groups that lacked private health insurance, promised that the problem of access would soon be history. Clearly, that expectation has not been fulfilled. Rather, developments in the 1980s suggest that the numbers at risk because of lack of insurance coverage for health care are increasing. It should be noted that the United States is unique among the developed economies in having based its general health insurance system on employer benefits, while providing coverage for the elderly and the poor as extensions of the Social Security system. What lies back of the serious miscalculation, what can