Mariner W K
School of Public Health, Boston University, MA 02118-2394.
Am J Public Health. 1994 Aug;84(8):1330-5. doi: 10.2105/ajph.84.8.1330.
Like most reform proposals, President Clinton's proposed Health Security Act offers universal access to care but does not significantly alter the nature of patients' legal rights to services. The act would create a system of delegated federal regulation in which the states would act like federal administrative agencies to carry out reform. To achieve uniform, universal coverage, the act would establish a form of mandatory health insurance, with federal law controlling the minimum services to which everyone would be entitled. Because there is no constitutionally protected right to health care and no independent constitutional standard for judging what insurance benefits are appropriate, the federal government would retain considerable freedom to decide what services would and would not be covered. If specific benefits are necessary for patients, they will have to be stated in the legislation that produces reform.
与大多数改革提案一样，克林顿总统提议的《健康保障法案》提供了普遍的医疗服务，但并未显著改变患者获得服务的法定权利的性质。该法案将建立一个委托联邦监管体系，各州将像联邦行政机构一样行事以实施改革。为实现统一的全民医保覆盖，该法案将建立一种强制性医疗保险形式，由联邦法律控制每个人有权享受的最低服务。由于宪法没有保护医疗保健的权利，也没有独立的宪法标准来判断哪些保险福利是合适的，联邦政府将保留相当大的自由来决定哪些服务将被涵盖，哪些不会。如果患者需要特定的福利，它们将必须在产生改革的立法中予以说明。
