A universal access plan: a step toward national health insurance?

There is increasing interest by the public and by many providers in the enactment of a universal access plan for the more than 60 million Americans who are now without health insurance benefits at some time during each year. After discussing the heterogeneous characteristics of those such a plan would cover, the reasons that some key players are now supporters of a minimal benefit plan, and the funding options for such a proposal, it is concluded that there is growing support for a universal access plan to be enacted soon. The almost insurmountable issues of such a plan involve the determination of eligibility and the specific benefits to be provided, the cost and administration of the new coverage, and the predictable increase in the nation's expenditure for health care services. This article concludes with the opinion that the passage of a universal access plan is a necessary and incremental step that will provide additional time for the discussion of whether and, if so, when the United States will be prepared to implement the final steps toward a more single-payer, centrally controlled health care delivery system.