by Regina E. Herzlinger, Barak D. Richman, Richard J. Boxer
JAMA. Published online February 27, 2017
A primary obstacle to achieving affordable universal coverage is the high costs of those with diseases or costly traumatic events – approximately 20% of individuals accounting for approximately 80% of health care spending. So, a key question is how to pay for their care. Some nations in the Organisation for Economic Co-operation and Development (OECD) rely on a governmental single-payer model to achieve universal coverage, but this approach is politically infeasible in the United States. As the United States relies on private-sector insurance, 3 other countries (Switzerland, Singapore, and Germany) that use private-sector insurance to offer affordable universal coverage provide some potentially helpful lessons.