Single-Payer National Health Insurance around the World Part VIIby admin on 07/10/2015 10:56 AM
In 2002 and 2003, we reviewed The Twenty Myths of health care reform. Now a decade later the authors have updated the book, renamed it, and added important 21st century data.
Lives at Risk by John C. Goodman, Gerald L. Musgrave, and Devon M. Herrick
(Continued from the April 2015 HPUSA Newsletter)
Chapter 22: Is Managed Competition the Answer?
Most of the problems of single-payer health care insurance are well known to policy makers and government officials and even to many ordinary citizens in countries with national health insurance. Many of the obstacles posed by the politics of medicine also are well known.
As a result, throughout the 1990s there was growing interest—particularly in Europe—in a new type of system, one in which health care resources would be allocated by competition in the marketplace rather than by politicians.
Such a system would not be a free market in the ordinary sense of that term; rather it would be a market in which the rules of competition were set and managed by government. So long as the competitors played by the rules, market forces rather than political forces would determine who got health care and how much. Such a system is called managed competition. And to obtain a model of it, Europeans turned, of all places, to the United States.2
Employees, for example, of the federal government make an annual choice among a dozen or more competing health plans.3 A similar choice system is in place for employees of many state and local governments.4 Many private employers also give employees a choice of health plans, and where these plans are independent organizations they effectively compete against each other to enroll members.5
The competition that exists in these programs, again, is not the same as one would find in a free market. It takes place under artificial rules managed by the employer or some other sponsoring organization. During its first term, the Clinton administration proposed such managed competition nationwide. Its adherents, including Stanford professor Alain Einthoven, still think this is the answer to the nation’s health care woes.6. . .