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Health reform in the United States: A social marketing perspective

The drain of health care expenditures on our national economy is a driving force in policymakers' analyses of how to achieve fiscal responsibility and accountability in these turbulent times. In addition, 16% of Americans do not have health insurance. At the beginning of the Clinton administration, a task force of over 500 policy experts, physicians, and other health professionals was convened to address controlling health care costs while also guaranteeing health care security to every American. The result of their work was the Health Security Act of 1993, first extensively circulated as a "Working Group Draft" dated September 7, 1993 (The White House Domestic Policy Council 1993).

The Health Security Act has as its foundation the principle of universality; all Americans must be guaranteed health coverage that cannot be taken away. Other guiding principles of the Act include recognized savings in health care costs for families, businesses, and government; preservation of consumer choice; maintenance and enhancement of high-quality health care delivery; reductions in the complexity and high administrative costs of the current system; and responsibility spread across segments of society to contribute to providing coverage. Standard benefit packages were outlined, a payment system was proposed that included employer mandates to pay at least 80% of the average employee premium, the creation of health alliances was envisioned as a way to restructure the insurance marketplace, and premium caps and cost control mechanisms were presented.


Lefebvre, R. (1994). Health reform in the United States: A social marketing perspective. Journal of Public Policy & Marketing, 13(2), 319-320.