MANAGED COMPETITION - AN ANALYSIS OF CONSUMER CONCERNS

Advocates for health care reform (representing a broad range of consti tuencies) raise serious concerns about the ability of managed competit ion to meet the health care needs of the American people. Similarities in managed competition proposals include establishment of a collectiv e purchasing authority, creation of health plans, standardization of r ules and requirements, and limitation on tax subsidies. Managed compet ition proposals vary as to whether they call for true universality, me aningful cost containment, and fair financing. The article raises ques tions about managed competition, including the technical feasibility; the link to employment; the role for insurance companies; severing the link between insurance and income, age, or health status; comprehensi ve benefits; cost containment; the role for managed care; universality of coverage; and the role for insurance companies to make treatment d ecisions.