An innovative proposal for the health care financing system of the United States.

With 40 million uninsured residents in the United States, we still spend more of our gross national product on health care than any other country in the world.1 Changes in the various health financing systems must occur if this problem is to be solved.2–4 A sound medical financing system that will meet the basic needs of the entire population requires efficient use of the medical dollar while ameliorating medical care inflation and encouraging innovation, productive competition, and progress toward quality cost-effective health care. Neither the current market-driven system nor the existing governmental quasi-National Health Insurance (NHI) Medicare and Medicaid programs meet these requirements.5–8 Single payer and nationalized health care in other countries suffer from underfunding, long waiting lines, inadequate facilities, rigid regulations, and frequently lack of patient choice.9 We propose new and innovative reforms that require a Federal Health Insurance Reserve System (FHIRS) to reduce ingrained errors and enhance the positive aspects of both the market and government systems. Whatever system develops a FHIRS will be pertinent, be it our new market-driven proposal or a single payer or national health insurance systems.