Health care reform in the 1990s: an analysis of the problems and three proposals

National health care reform is arguably the most important domestic policy issue of the 1990s and certainly is one of the most difficult and pressing of current social issues. It also is clear that health care reform is as much a political as it is a public policy issue. This article evaluates three health care reform proposals by members of the U.S. Congress--one single-payer model and two "play or pay" models--to analyze how well they responded to the underlying crisis in the American health care system. Specific criteria for evaluating health care reform proposals are delineated, and an evaluation of the competing models is provided.