HEALTH REFORM - WHAT WILL IT TAKE TO PASS

The health care reform debate has begun in earnest, but the outcome fo r 1994 is highly uncertain. Divisions among Democrats on health care r eform are very serious, with conservative Democrats closer to mainstre am Republicans than to their own congressional leadership on the key i ssues of spending limits, price controls, and employer mandates. Becau se 1994 is an election year, and given the commitment of the president to reform, passage of legislation that is somewhere between a less re gulatory form of managed competition and incremental reform is possibl e. But because of the divisions within Congress and the president's ov erly ambitious starting point, near-term passage is not inevitable.