Health Care: Some New Proposals

The disruption caused by our chaotic medical system has reached such proportions that mainstream medical thought is beginning to call for a major revision of health services. As costs sprout upward the already limited care for low-income patients is further eroded while the middle classes increasingly feel the squeeze. Arnold Relman, the influential editor of the New England Journal of Medicine, suggests that “we urgently need a new and more comprehensive approach to health policy. . . .” Only drastic measures can “repair or replace our present disastrously inadequate health care financing system.”

The January 12, 1989, Journal contains two proposals for reform. The first is relatively decentr...