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Clinton's health plan: Prudential's choice
S Woolhandler1, D U Himmelstein
1Center for National Health Program Studies, The Cambridge Hospital/Harvard Medical School, MA 02139.
Insights
President Clinton's managed competition health care reform may increase bureaucracy and reduce patient choice. Evidence does not support its ability to lower costs or improve quality, making coverage expansion unlikely.
Area of Science:
- Health policy analysis
- Healthcare economics
- Public health administration
Background:
- The Clinton administration proposed a managed competition model for U.S. health care reform.
- This model aimed to restructure the healthcare system through market-based mechanisms.
Purpose of the Study:
- To critically evaluate the potential impacts of President Clinton's proposed managed competition model for health care reform.
- To assess the likelihood of cost containment and quality improvement under this reform strategy.
Main Methods:
- Analysis of the proposed managed competition model's core tenets.
- Review of existing evidence regarding competition in healthcare markets.
- Assessment of the potential consequences for healthcare corporatization, patient choice, and insurance market structure.
Main Results:
- The managed competition model is predicted to accelerate healthcare corporatization.
- Potential outcomes include increased bureaucracy and reduced patient autonomy.
- Concerns exist regarding the lack of evidence for cost reduction or quality enhancement.
- The feasibility of expanding health coverage is questioned due to uncertain cost containment.
Conclusions:
- The proposed managed competition model may lead to a less accessible and more concentrated healthcare system.
- The plan's effectiveness in achieving stated goals of cost and quality improvement is doubtful.
- The proposed healthcare reform's potential negative consequences outweigh uncertain benefits.
Abstract:
President Clinton has proposed a managed competition model for health care reform. This strategy would accelerate the corporatization of U.S. health care resulting in more bureaucracy, less patient choice, and a health system owned by a few insurance giants. There is no evidence that competition or other central features of Clinton's plan can lower costs or improve quality. Because cost containment is doubtful, the promised expansion of coverage is unlikely to be implemented.