Outlook for Health Care Reform

It is speculative to project that the U.S. health-care system will evolve along the lines of market-based proposals, managed competition plans, or by more traditional "play-or-pay" or national health insurance proposals. Pay-or-play plans require firms to provide basic health insurance to employees and their dependents ("play") or pay a payroll tax to cover enrollment in a public health-care plan ("pay"). Proposals for national health insurance envision replacing the private health insurance market with a single national health insurer. National health insurance would be funded through taxes and care would be free (as in Canada) or provided at a low cost-sharing level.

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