Private or public approaches to insuring the uninsured: Lessons from international experience with private insurance

While the United States, virtually alone among developed countries, relies primarily on private health insurance to deliver access to health care serv ices, private health insurance is not unknown elsewhere in the world. In th is Article, Timothy Jost surveys the mixed public anti private health insur ance systems of Australia, Chile, Germany, and the Netherlands as well as t he largely public systems of Canada, France, and the United Kingdom. Ne sho ws that countries that place significant reliance on private health insuran ce also regulate the private insurance marker heavily; only,where private i nsurance merely supplements universal public insurance is the private marke t largely unregulated. Professor Jost concludes from his comparative analys is that market-reliant systems are unlikely to reduce the growing number of Americans who are uninsured, and that the differences between highly regul ated private insurance systems and largely public insurance systems are les s pronounced than generally assumed. While the United States politically is unlikely to move towards public insurance, he writes, a turn towards great er privatization would tend to worsen, rather than improve, the problem of the uninsured.