Presidential candidates, governors, and members of Congress are advancing proposals to expand health insurance coverage to all Americans--the most important step in improving access to quality health care. This report, prepared for The Commonwealth Fund Commission on a High Performance Health System, explores the different options and how each may not only increase coverage for the uninsured, but also improve quality and efficiency and gain control over spiraling health care costs. Proposals are grouped into three approaches: tax incentives and the individual insurance market; mixed private--public group insurance with shared responsibility for financing; and public insurance. The Commission believes the most pragmatic approach to coverage for all is mixed private--public group insurance that builds on the best features of our current system with shared responsibility for financing from individuals, employers, and government that minimizes dislocation for the millions of Americans who currently have good coverage.
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