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As for truly comprehensive medical coverage, the gaps of unmet needs are still greater. There are 155 million who have insurance against surgical expenses, leaving 50 million unprotected, and 130 million insured against "regular medical expense," leaving 75 million unprotected. About 67 million subscribers have "major medical" coverage, which repays them for 70% to 80% of actual outlays for virtually all medical expenses, including prescription drugs. Under whatever type of plan, coverage for the costs of mental illness is spotty and in most cases inadequate. Only 3,000,000 Americans have insurance for dental care.
In 1948, President Harry S. Truman's Federal Security Administrator, Oscar Ewing, with his boss's backing, declared that the U.S. must "provide that all people shall have access to such health and medical services as they require through a system of insurance covering the entire population." The plan was to be financed by payroll taxes rising to 4%; it would be administered by the states with the Federal Government serving only as the collecting and disbursing agent; patients would have free choice of doctor, and doctors would have the right to reject patients; doctors could join the plan or not, as they chose. Despite these highly flexible provisions, the Truman-Ewing plan was denounced as "socialized medicine" by the A.M.A., which succeeded in killing it.
In the Hopper. At least half a dozen plans for U.S. national health insurance have now been formally proposed and introduced in Congress or are in their final drafting stages. None of these originated in Finch's HEW, and none is likely to. In its concern for budget balancing and combating inflation, the Nixon Administration does not sufficiently recognize the potential savings —certainly in health and lives, if not in money—from a national program to insure health care, including preventive medicine, for all.
What the Administration is doing, commendably, is trying to iron out some of the wrinkles that have caused needless overruns in the costs of Medicare and Medicaid. It is proposing that contractors (such as Blue Cross, Blue Shield or group health plans) be authorized to assume responsibility for the total care of Medicare patients for a flat annual fee that would be no more than the current per-patient costs of Medicare from both taxes and the voluntary part.
While most of the drive for comprehensive health insurance is coming from Democrats, they do not have the field to themselves. Among Republicans, New York's Governor Nelson Rockefeller has a plan for both his state and the nation; Massachusetts' Governor Francis W. Sargent has a state scheme, and New York's Senator Jacob Javits has introduced a national bill. Main features of the principal plans: