I propose … the view that when the market fails to achieve an optimal state, society will, to some extent at least, recognize the gap, and nonmarket social institutions will arise attempting to bridge it.

The choice is no longer between the traditional type of private practice on the one hand and voluntary health insurance on the other. … The alternative in the future is between some form of nonpolitical voluntary insured medical service, such as the state society is sponsoring, and something which will undoubtedly be much worse – state medicine, compulsory health insurance, socialized medicine, or something else.

Instead of turning the current system, which now insures 85 percent of Americans, on its head in order to extend coverage to the rest, the plan I will outline … will strengthen existing coverage and focus like a laser on the remaining 15 percent, those without coverage.