A national health service and social security

With the new federal administration, there is wide-spread belief that at long last some type of National Health Insurance legislation will be enacted in the near future. The scope of that legislation, in population coverage and health benefits, is bound to depend on the strength and unity of public demand. It is unfortunate, therefore, that at this critical hour voices should be raised rejecting National Health Insurance and calling for general revenue financing of a National Health Service. This is regrettable in the light of both world-wide and American experience on the issue. Improved organization of health service delivery for everyone, through teams of salaried personnel in a regionalized network of public facilities, is clearly desirable. World-wide trends are moving in that direction, and this pattern is a reasonable goal for the United States as well. To expect such a goal to be attained in current-day America, however, through 'progressive taxes on personal wealth, taxes on corporate profits and general revenues'-in the words of the newly launched Committee for a National Health Service - is to flirt with a dangerous illusion. To understand how a universal and effective system of comprehensive health service can be achieved in a free-market economy, such as characterizes the United States, requires analysis of the issue into its major components. One component is the method of financing health services, and the other is the method of delivery of those services. Each of these components shows a clear evolutionary development in the capitalist world, and each has distinct political implications.