Curtis Rick, Neuschler Ed
Institute for Health Policy Solutions in Washington, DC, USA.
Health Aff (Millwood). 2009 May-Jun;28(3):w431-45. doi: 10.1377/hlthaff.28.3.w431. Epub 2009 Mar 24.
Moving toward universal participation in health insurance using a "shared responsibility" approach requires new, more accessible, and more efficient ways for people who are not offered employer coverage to obtain coverage. California's recent health reform plan-which failed to pass-incorporated individual market reform and choice-pool constructs to achieve critically important risk spreading, assure solvency, and reduce cost shifts. These measures, as well as the considerations that led to their design, offer important insights for health reform at the federal level.
采用“共同责任”方式迈向全民医保参与，需要为未获得雇主医保覆盖的人群提供新的、更便捷且更高效的途径来获取医保。加利福尼亚州近期的医保改革计划（该计划未获通过）纳入了个人市场改革和选择池架构，以实现至关重要的风险分摊、确保偿付能力并减少成本转嫁。这些举措以及促成其设计的考量因素，为联邦层面的医保改革提供了重要的见解。
