Reduction in the price of oil in the mid-eighties forced the Saudi government to adopt new health policies in order to finance health services. On August 11, 1999, the Saudi government approved a new Mandatory Cooperative Health Insurance Program (MCHIP). This new health policy was enacted to replace the current policy of providing free health care. MCHIP is intended to reduce the financial burden on government by sharing the costs of health care with the public. This study had a dual purpose: to analyze the components of MCHIP program by comparing it with the American health system, and to investigate the perceptions of Saudi students attending American universities towards MCHIP program, based on the students' experiences with the American health care system.A multiple methods approach was used to conduct the study. A descriptive approach was employed to compare components of the MCHIP program with similar components of the American health care system. A survey method was used to investigate the perceptions of Saudi students attending American universities toward the new MCHIP program. Scales were constructed to measure the students' expectations of the MCHIP program with respect to cost, quality, and access of health care. Additional scales were used to measure the students' knowledge of the MCHIP program, knowledge of the American health system, and total health insurance knowledge. An electronic survey was posted on the VCU SERL Web page, and a link was e-mailed to 2210 Saudi students using a list provided by the Saudi Arabian Cultural Mission (SACM). The survey response rate was 40.6 percent.During the first phase of the research, the comparison to American health care identified areas in which the United States of America experience could be useful in promoting effective implementation of the MCHIP program in Saudi Arabia. In sum, the comparison indicated that the American health insurance model may not be an ideal approach for the Saudi health system. During the second phase of the study, survey results indicated that students expected MCHIP implementation to increase total health costs, improve quality of health care, and increase access to health care in Saudi Arabia. The students' total knowledge of health insurance had a significant effect on students' perceptions of cost and a non-significant effect on their perceptions of quality and access to health care. In order for the MCHIP program to be effectively implemented, study results point to the need for regulation of the Saudi insurance market and for health insurance-related systems (such as for coding, billing, and maintaining effective medical records) to be established. American health insurance system models are not ideal for the Saudi health system, although certain aspects may be useful. To promote success, the MCHIP program should be structured to meet the goal of providing affordable and accessible quality health care to the population, based on Islamic principles.