Recent polls suggest that about two thirds of Americans believe that the federal government should guarantee health insurance for everyone.1 Although universal access to health care should be a national priority, disagreement among politicians about what sort of system is most compatible with the values of Americans—disagreement that often reflects the influence of special interest groups and detachment from the lives of ordinary citizens—continues to sabotage progress in achieving universal access.
Among those who favor guaranteed access to health care, a point of controversy is whether we would be better off with a single-tiered or a multitiered health care system. In a single-tiered system, everyone would receive the same health care benefits, and people could not buy additional services. In contrast, a multitiered system would allow people to purchase services beyond those provided in the first tier. In this issue of the ARCHIVES, Krohmal . . . [Full Text of this Article]
5 QUESTIONS TO CONSIDER IN THINKING ABOUT TIERED HEALTH CARE
In What Kind of System Would Tiered Health Care Be Situated?
In the United States, Is There Really a Level of Scarcity That Mandates a Tiered System?
Exactly What Sorts of Interventions Do Krohmal and Emanuel Envision That Would be Available to Second-Tier Patients But Not to First-Tier Patients?
Why Shouldn't Patients Get Whatever They Want as Long as They Will Pay for It?
Who Pays for Downstream Consequences of Interventions Initiated in Upper Tiers?
CONCLUSIONS
AUTHOR INFORMATION
