Economists would have formulated several aspects of the health care re
form debate differently than policy entrepreneurs did. Economists woul
d have questioned whether health care costs must be contained and whet
her either competition or global budgets were a ''magic bullet'' for d
oing so. They also would have emphasized the distortive costs of subsi
dies and taxes necessary to reach universal coverage, as well as the s
hakiness of the arguments about international competitiveness and exce
ss insurance industry profits.