Federal provision of health care: creating access for the underinsured

Access to health care for the underinsured in America is a major current policy issue. Federal provision of health care has not been evaluated seriously as part of the solution to the problem despite the presence of federal health care provided to veterans, the class of Americans most completely guaranteed universal access. We first explore the arguments for and against universal access, clarifying issues but yielding no definitive solution. Then the federal health care system for veterans is used as a model for exploring problems that must be solved in a universal access plan. The discussion focuses on the effects of competition for patients and health care resources on costs, innovation, regulation, and quality.