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PubMedDate not supplied

Controlling the rate in community rating--experts aren't sure how.

What premiums states pay under community rating will be determined by how much they spend on health care. But it's not clear how spending is affected by prices, utilization, disease rates, and behavior. The answers will test Americans' commitment to one another.

Aged↗
PubMed1993

Who's in charge?

President Clinton's health care reform plan avoids the appearance of government control by diffusing and delegating authority to a host of new institutions. The net result, ironically, may be a system that is less accountable to the public than one in which government's role is clearer.

Cost Control↗
PubMed1995

Reinhardt on reform. Interview by Donna Vavala.

Almost since the federal government took its giant step into health care delivery and financing in 1965 with Medicare and Medicaid, the emphasis in Washington has been on reducing the costs of health care. Almost all federal health law subsequent to those two programs has been aimed at cost control, even when the titles of the bills promised a more noble purpose. The most notable exception is the law establishing end-stage renal disease coverage, but it has become a prime exacerbator of rising costs. Not even the designers of the federal programs envisioned how quickly health care costs would rise and how substantial the increases would be. The federal tab in 1993 was $280.6 billion. In 1960, it was $3 billion and in 1970 it was $17.8 billion. And overall health care costs have followed a similar curve, growing from 5.3 percent of the U.S. GDP in 1960 and 7.4 percent in 1970 to 13.8 percent in 1993. The end is not in sight. Economists are predicting growth to 18 percent of GDP by the next century. Uwe E. Reinhardt, PhD, James Madison Professor of Political Economics in the Woodrow Wilson School at Princeton University, does not believe that the "bite" will become that large, but he does expect increases to continue into the near future. In the interview recorded in this article, Professor Reinhardt assesses both the current and his predicted financial scenario for the health care field.

Cost Control↗
PubMed1994

The Clinton health care reform proposal: efficiency, fairness, and the role of government.

In a detailed evaluation of the Clinton reform proposal, this article deals with the many thorny yet pragmatic problems concerning the proper role of government in reforming the health care system. Areas of focus include mandatory coverage, information networks, market failure, and the ability of government-controlled systems to produce efficiency and fairness for the health care consumer. It is the author's opinion that the plan needs to be resubmitted with substantial revisions.

Economic Competition↗
PubMed1994

Choosing among health plans.

The health care reform system that is ultimately adopted, suggest the authors of this analysis, should rely on market forces, rather than government regulation, to reduce cost and improve quality in our health care delivery. A major portion of this paper compares the Health Security act (the Clinton proposal), the American Health Security Act (the McDermott bill), the Health Equity and Access Reform Today, HEART (the Chafee proposal), and the Managed Competition Act (the Cooper bill). The article focuses on the major areas of difference between these alternative proposals in the extent to which they would achieve true market-based reform, small group reform, universal coverage, and financing mechanisms.

Evaluation Studies as Topic↗