The new health policy: promises and pitfalls

Our past health care policies--policies relating to provision of services, development of medical resources, public financing of care, and regulation--constitute a legacy greatly affecting our future. A new health policy must accommodate the political, social, and economic manifestations of that legacy. In the coming decade, the health care policy debate will be dominated by the reinvigorated champions of "competition." The banner of pro-competitive reform could be used to cloak changes in programs that give at best nominal help to alternative practice forms, and at worst simply force consumers to bear greater proportions of the cost of care.