SOWING THE SEEDS OF REFORM IN 1994

The prospects for reforming health care financing revolve around five questions: (1) Will Congress mandate universal coverage? (2) Will Cong ress require employers to pay most of the cost of employee coverage? ( 3) Will Congress authorize effective limits on health care spending? ( 4) What role should regional health alliances play in the reformed sys tem? (5) How much change in health insurance arrangements can be imple mented over the remainder of this decade? The author argues that the p rospects are slight for quickly implementing reforms as sweeping as th ose that President Clinton has proposed. But prospects are good for be ginning a process that will lead to universal coverage and effective c ost controls. The key is the creation of regional alliances.