Health care reform in the United States: Implications for the elderly

When and if the United States develops health reform that systematically addresses long-term care needs remains highly speculative. Issues of universal access, finding and most importantly cost containment will undoubtedly dominate any future health care deliberations. This article (1) outlines the major problems associated with the introduction of universal access to health care services; (2) develops a set of analytical concepts with which to examine the suggestions for providing and funding universal access without major cost increases; and (3) explores the political difficulties involved in changing the existing health care system. The article concludes that the State will continue to be limited in its ability to intervene on behalf of the elderly and the interests of the medical industrial complex will continue to prevail. Therefore, ''patchwork'' coverage will remain a fixture in the United States with increasing dependence on private-for-profit HMOs to provide medical care services.