Any reform strategy faces the limitations of using health insurance as the only tool to accomplish new financing goals. As the dominant fiscal tool in the medical care sector, health insurance is designed to function over short time frames, focus- ing on episodes of care. Yearly renewals of eligibility and ongoing churning in in- surance markets preclude any real utility of health insurance as a mechanism for investing in the long-term health capital of a , health insurance, as currently designed and operated in the United States, does not provide the fiscal wherewithal to develop and implement integrated systems of care. In fact, con- gressional attempts to make.
