Berman Stephen
University of Colorado School of Medicine, CO, USA.
Health Aff (Millwood). 2007 Mar-Apr;26(2):394-404. doi: 10.1377/hlthaff.26.2.394.
This paper describes four alternatives for expanding childhood insurance coverage, discusses key health policy issues, and assesses the political possibilities for enacting universal coverage. Alternatives are (1) a single federal child health program for all children; (2) a hybrid federal child health program (replacing Medicaid and the State Children's Health Insurance Program [SCHIP]), combined with employer coverage; (3) a new federal wraparound program for the uninsured (that keeps the existing Medicaid program); and (4) expansion of SCHIP. Key policy issues include the type of universal coverage, use of competing commercial health plans, financing, employer and individual mandates, and the definition of benefits.
本文描述了扩大儿童保险覆盖范围的四种方案，讨论了关键的卫生政策问题，并评估了实施全民覆盖的政治可能性。方案包括：（1）为所有儿童设立单一的联邦儿童健康计划；（2）混合联邦儿童健康计划（取代医疗补助和儿童健康保险计划 [SCHIP]），并结合雇主提供的保险；（3）为未参保者设立新的联邦补充计划（保留现有的医疗补助计划）；（4）扩大儿童健康保险计划。关键政策问题包括全民覆盖的类型、商业健康保险计划的竞争使用、融资、雇主和个人强制参保规定以及福利的定义。
