UNIVERSAL HEALTH CARE COVERAGE IN THE UNITED STATES: Barriers, Prospects, and Implications.

This article examines barriers to and prospects for universal health coverage in the U.S. On September 22, 1993, U.S. President Bill Clinton, in a televised address, introduced the Health Security Act (HSA), which would have provided universal health care coverage. The author identifies major obstacles and possible routes to universal coverage, addresses current problems with the U.S. health care system, and discusses the debate over Medicare and Medicaid. The history of the HSA provides insight into barriers to universal coverage in the U.S. Perhaps the chief obstacle is the lack of political support for health care reformers. Another obstacle to universal coverage is opposition from powerful interest groups. A final obstacle was the lack of a crisis that would motivate people to change the health care system. The U.S. health care system continues to have serious problems, particularly in the area of coverage. First, 40.3 million people lack health insurance, and 29 million people have inadequate coverage. Second, health care costs remain a problem. And third, the U.S. faces the corporatization of health care and the subjection of medicine to the morality of the marketplace.