It is useful, at the outset, to note the possibility that the various papers presented at this conference will to some extent, duplicate each other. All of us, through the good offices of the individuals at the Leonard Davis Institute of Health Economics, have attempted to keep the amount of repetition to a minimum. Perhaps, however none of us can be fully satisfied with each other’s introduction to the subject of national health insurance. Thus, what appears to be repetition may involve some change in nuance. For this reason, I being with some general introductory remarks.
In the last few years, and particularly in the last few months, national health insurance ( NHI ) has become a live issue . Most of us would probably agree that today some from of national health insurance appear closer to enactment than any of us would have imagined just four or five years ago. I believe it is important to try to distinguish the forces that have brought us to this point in time. If we understand some of the reasons that national health insurance has projected itself into the limelight, then we may better understand some of the objectives of the program and some of the problems which it is hoped NHI would solve. This understanding would, therefore, provide yet another basis for a critical evaluation of the various plans submitted, that is, do they address themselves to the problems that appear to be troubling people or are they the construction of excellent analysts who are desirous of meeting their objectives rather than those of the people ?
The ideas concerning NHI have been around a very long time and there has been sporadie discussion of the issues. But the momentum behind today’s proposals has a certain special quality a quality perhaps best described by the words, “realism,” and “immediacy.” The serious discussion of national health insurance that we witness, I believe, is a response to the pressure coming from below from constituents, from union members, from the general public. If I am correct, this is an important datum. It says that proposals for national health insurance have arisen in response to existing problems. This does not necessarily mean that national health insurance represents the only solution to the problems ; that is a matter that bears discussion. I suggest, however, that if national health insurance is rejected as a solution, other solutions must be offered, since the problems are real and being voiced with increasing frequency. We must, therefore, determine what some of the problems are. What is it that the public is concerned about ?
