Abstract

The Health Reform Game: The Major Players Start Dealing

The article presents information about an effective, simple and popular proposal, a universal health insurance program. The program substitutes a single public insurer for the current multiple private insurance companies. But during the campaign U.S. President Bill Clinton rejected this idea without any public debate and embraced managed competition. Managed competition as it is described by its proponents has three main features, health care is provided by doctors working for health maintenance organizations (HMOs) that compete for patients by keeping costs down; health consumers join large purchasing groups powerful enough to bargain with HMOs for lower costs and everyone is required to pay more money in insurance premiums, thereby encouraging the choice of low-cost HMOs. Managed competition is not universal health insurance; it will not cover a single uninsured American.