Sauntharajah Y, Tan S Y
University of Hawaii, USA.
Hawaii Med J. 1995 Apr;54(4):464-7.
Universal coverage requires costcontainment. Working models of health care coverage from Hawaii, Oregon, and Singapore address different aspects of cost-containment. Hybridizing the three produces the following system: A percentage of an individual's salary is mandatorily set aside in an individual medical account. Using these savings, the individual purchases catastrophic medical insurance with a managed care organization. Residual funds are used as a deductible or co-payment and to purchase additional medical services as desired. Enough funds should accumulate during an individual's working life to enable continued coverage after retirement. The basic health care package needs to be limited and is defined by a systematic and rational process based on cost-benefit analysis and democratic consensus regarding priorities and coverage. Medicaid recipients get the same basic package from managed care organizations as that available to the rest of the population; low wage earners receive sliding-scale subsidies from the government. Co-payments and deductibles remain in place except for beneficial preventive services.
