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A Solution for the United States?

Richard B. Saltman, PhD

JAMA. 1992;268(6):774-779.

Abstract
Although tax-based and social insurance—based forms of single-source financing differ in how they raise funds, they share a common set of structural characteristics. In particular, they both enable publicly accountable authorities to control aggregate expenditure levels by creating a countervailing power to pressures for increased expenditures from providers. While major reform initiatives are under way in European single-source financing systems, these initiatives have so far sought to improve the efficiency, effectiveness, and/or responsiveness to patterns of service delivery without reducing their commitment to universal access to necessary care. The article concludes with a review of the advantages and disadvantages that could accompany the introduction of a single-source financing system in the United States.

(JAMA. 1992;268:774-779)

Author Affiliations
From the Division of Health Policy and Management, Emory University School of Public Health, Atlanta, Ga.

Footnotes
Reprint requests to Division of Health Policy and Management, Emory University School of Public Health, 1599 Clifton Rd NE, Atlanta, GA 30329 (Dr Saltman).

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