The research will identify how national health insurance in other developed countries deals with the principal difficulties that beset American health finance, viz.: coverage of persons without the income subject to social security taxes (i.e., the poor, the unemployed, the retired); how insurance funds cope with the very expensive patients whose costs greatly exceed their own payments (especially the aged); long-term care and other benefits for those not requiring acute medical care; new benefits not belonging to the traditional services of doctors and hospitals (e.g., mental health, drugs and dentistry); adoption of new technically advanced benefits; limits on benefits claimed by high-utilizing patients (such as the chronically ill); financing of health insurance by combinations of payroll taxes, voluntary premiums, government subsidies, and patient out-of-pocket payments. The research will be conducted by interviews and collection of documents in the countries with health insurance that are most relevant to the United States, viz., France, West Germany, Netherlands, Belgium, Switzerland, and Italy. Inclusion of Italy will provide information about how countries cope with the bankruptcy of the health insurance system, a peril that faces others. The research is one of a series about how other developed countries can provide lessons for the organization of health care financing in the United States. This new project builds upon our earlier research devoted to other topics, viz., how doctors and hospitals are paid in Europe.
