Implications of health-care reform proposals for black Americans

A recent increase in the number of black Americans who lack public or private health insurance means that current proposals to reform the U.S. health-care system have particular relevance for the black community. This paper reviews the major reform proposals offered by President Clinton and Congressional leaders with an eye toward estimating the possible impact on black Americans. The proposals offer concepts ranging from managed competition and "play or pay" to caps on health-insurance premiums, incentives for primary-care providers, "sin" taxes, and outcomes analysis. Though some of these concepts offer opportunities for improving black Americans' access to quality care, most have potential shortcomings that could worsen health status in the black community.