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Health Care Reform as Seen by a General Economist

James Tobin

No 1073, Cowles Foundation Discussion Papers from Cowles Foundation for Research in Economics, Yale University

Abstract: Universal coverage, it is argued, implies universally required insurance, to avoid adverse selection into last-resort care implicitly guaranteed. It also entails community rating, such that insurers cannot choose among risks. Individual mandate makes more sense than employer mandate. A system is proposed in which individual can choose among a government Medicare-like plan and private insurance offering equivalent services. Means-tested assistance would help individuals pay premiums.

Date: 1994-06
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