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date: 16 April 2021

Abstract and Keywords

This article explores the development, the present condition, and the likely future of private health insurance in the United States. It emphasizes the three kinds of fragmentation that mark American health care: scattered oversight, multiple risk pools, and inchoate government. I pay special attention to the health-care challenges we face, the persisting patterns of inequality, and the important but limited reforms introduced by the Affordable Care Act.

Keywords: health insurance, employer health insurance, risk pools, insurance regulation, health politics, Affordable Care Act, health costs, health disparities, solidarity, managed care, Medicare, Medicaid

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