Grey Lit: A Sustainable Health System for All Americans - Len M. Nichols

Posted by CHPRE Staff Publications Sunday, July 1st, 2007

Summary:

America’s social contract — the complex, largely unwritten deal between workers, employers, and government that gives individuals the security they need to navigate a dynamic economy — is eroding. The arrangements of our existing social contract no longer make sense in an economy characterized by global labor markets, shortened job tenure, heightened capital mobility, rapid technological change, and increased pressure for short-term profits. Ensuring that every American can access the goods and services necessary to enjoy a productive and enterprising life should not depend on where you work, where you live, or what you believe. The American social contract should be citizen-based.

One of the most glaring shortcomings of the current social contract is the link between health care and employment status. Creating a citizen-based social contract will require remaking our health care system so it becomes sustainable and accessible, one where health care benefits are portable and tied to the individual, rather than to his or her place of employment. Such a system can be built upon the essential pillars of personal responsibility and shared responsibility. Mandates to buy insurance and subsidies to help people afford to do so will be balanced with the creation of an insurance marketplace that is affordable and a delivery system that works in terms of both cost and quality.

“A Sustainable Health System for All Americans,” New America Foundation, Next Social Contract Policy Proposal, July 2007.

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