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Expanding health insurance coverage.

Article Excerpt
This is shaping up to be a year for significant changes to the American health care system. Congress has already enacted into law the reauthorization and expansion of the State Children's Health Insurance Program (SCHIP), funded largely through a 62 cent a pack increase in the federal tax on cigarettes. Extensions to Medicaid and funding for health information technology were passed in the recently enacted stimulus bill. And the Montana Legislature, at this writing, continues to debate the funding of the Healthy Montana Kids initiative approved by the voters last November.

Given the rhetoric of last year's presidential campaign, when both candidates promised more comprehensive changes, expectations are running high. But finding the consensus--and the money--that is needed to make significant changes to the structure of health care delivery and finance remains, as always, an obstacle to change.

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Where We Are Today

The health care system in the United States has evolved in a way that is distinctly different from that of other industrialized countries. The majority of the U.S. population (62 percent) has group health insurance from private companies that is offered--and substantially paid for--through arrangements with their employers.

This peculiar system--an artifact of tax law changes made during...

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