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The American Public and the Critical Choices for Health System Reform

Robert J. Blendon, ScD; Mollyann Brodie, MS; Tracey Stelzer Hyams, JD, MPH; John M. Benson, MA
JAMA. 1994;271(19):1539-1544. doi:10.1001/jama.1994.03510430095043.
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AN ARTICLE published 2 years ago in The JOURNAL identified the seven critical choices that are necessary to craft any national health plan.1 Every proposal for reforming the health care system must, at a minimum, address these critical issues: (1) Should everyone be guaranteed health insurance? (2) How should universal coverage be provided? (3) How should universal coverage be paid for? (4) Should Medicaid be retained? (5) What health benefits should be included in a national plan? (6) How should health care costs be controlled? and (7) Who should administer a national health plan?

During the subsequent period, public opinion has been an important participant in the debate over health system reform. Almost every week newspapers report the latest poll results on health system reform. These survey findings are continuously cited by proponents of various reform proposals to buttress their particular positions. In this article we undertake a comprehensive


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