It is evident that within the next few years we shall see some major extensions of governmentally supported insurance against the costs of health services. Even the American Medical Association (AMA) and the insurance companies see the handwriting on the wall and are coming up with their own proposals. The mounting insistence that there should be further governmental involvement in this area stems from two major influences. First, the very existence of Medicare has demonstrated that public compulsory health insurance is feasible. Despite its many well-known weaknesses, Medicare obviously has brought considerable financial relief to, and broadened access to health services for, many millions of the aged, and it is popular. Inevitably, there is growing pressure to extend a similar service to those whose economic circumstances differ little, if at all, from those of the mass of the aged. If aged social security beneficiaries, why not disabled beneficiaries? If the disabled, why not survivor families? We are already seeing, too, criticism of the limited scope of the types of health services covered by the insurance program. Why exclude preventive checkups, or drugs, or certain other components of comprehensive care? If paid-up insurance is feasible for hospital and institutional care, why is it not equally applicable to physicians' services? Even more influential in stimulating a demand for an extension of compulsory health insurance is the impact on all sections of the population, and not merely the aged, of the sharply rising costs of health services, so especially pronounced since 1965. These increased costs are reflected in a continuing upward trend in the premiums charged by private health insurers, both profit and nonprofit, or in some curtailment of benefits so that the contribution these institutions can. make to moderating the financial burden on even middle-class families will inevitably decline. They may indeed be in danger of pricing themselves out of the market. The result has been a flood of bills and proposals and plans. The AMA has made proposals (1, 2); so have the Equitable and the Aetna insurar4ce companies (3). Governor Nelson A. Rockefeller has again introduced a health insurance bill in New York (4), and the Committee on Human Resources of the National Governors' Conference has endorsed a system of universal health insurance (5) following the general lines of the earlier Rockefeller bill. The AFL-CIO has made some proposals, now embodied in the Griffiths bill (6). The Committee for National Health Insurance (CNHI), formed by the late Walter Reuther, has been intensively working on a proposal for national health insurance, which, under the title of the Health Security Act, has now been introduced by Senator Kennedy (7). Among other bills are those sponsored by Representative Dingell (8), jointly by Representative Fulton and Senator Fannin (9, 10), and by Senator Javits ( 11). Organizations such as the American Public Health Association also have committees working on a program for national health services. It is obvious that space alone will preclude a detailed consideration of each and all these numerous schemes. In any event, a detailed comparison of their features would be extremely repetitious and boring. I propose instead to discuss some of the more crucial features and problems of any health insurance system and to examine how these are dealt with by some of these plans. As we consider them, it is well to bear in mind the objectives to which almost everyone gives lip service. What we are seeking, I assume, is a program that assures universal access to comprehensive and continuous health services of high quality, delivered under circumstances that are convenient, comfortable, and dignified and in a manner that is efficient and economical. Several features of current propos