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1 National Health Insurance 1950

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                        PUBLIC AFFAIRS


                              ABSTRACTS

LEGISLATIVE REFERENCE SERVICE  • THE LIBRARY OF CONGRESS  * WASHINGTON, D. C.

                                                      March 1950
                                               Second Edition, November 1950
                          NATIONAL HALTH INSUANCE                   No. 6

   The Aroposals

        Proposals have been made that a national system of compulsory health
   insurance is necessary to protect the general welfare and to round out the
   existing Social Security program. A number of bills which would provide
   Federal assistance in medical care have been introduced in the Eighty-first
   Congress. The three major proposals are based upon the assumption that some
   form of Federal assistance is required, but differ as to the form it should
   take. The Adinistration bill (S. 1679) outlines a compulsory health in-
   surance system based on a contributory payroll tax. The Taft bill (S. 1581)
   calls for Federal grants-in-aid to States to underwrite and expand existing
   State and local programs for the medically indigent . The Flanders-Ives
   bill (S. 1970) proposes Federal subsidies, furnished through the States, to
   help develop a national system of private voluntary prepayment group in-
   surance plans.

       Although discussion has centered around these three bills, alternative
   suggestions have also appeared proposing (1) to stimulate voluntary health
   insurance bf providing for income tax deductibility for premiums; (2) to
   subsidize voluntary plans for lw-income groups exclusivelly (3) to provide
   compulsory insurance covering medical bills of over $25 or $50; and (4) to
   place the Federal Government in the role of the insuree. The three major
   bills (S. 1679, S. 1581, and S. 1970) are omnibus measures which also call
   for Federal Aid to Medical Education, liberalization of the Hospital Survey
   and Construction Act, increased Federal aid for State and local public health
   projects, maternal and child health services, and health study and planning.
   On the whole, there Is similarity in the provisions of the bills with respect
   to these objectives, and for this reason the material in the follming ab-
   stracts covers only the medical care proposals, all of which call for some
   form of Federal assistance but differ widely as to the form it should take.

   Background of the Proposals

       When a system of national medical care is considered, the question im-
  mediate2y arises: does or does not the present state of the nation's health
  require Federal intervention? Two major weaknesses are impropqr distribution
  of health personnel and facilities, and the high and unpredictable costs of


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