Competing Solutions

Joseph White

doi:10.5771/9780815714378

Summary

With health care reform at the top of the domestic agenda, this volume assesses the Clinton administration's proposals and several alternative plans by discussing how six other countries have organized health care finance and delivery to achieve universal access to comparable quality care at much lower costs. The six countries examined—Australia, Canada, France, Germany, Great Britain, and Japan—reveal both the variety and fundamental similarities of medical care systems in the rest of the industrialized world.

Joseph White uses foreign experience to indicate the proper direction for American reform and to identify interesting alternatives that suggest compromises for what are usually presented in the U.S. as "either-or" choices. Examples include the role allowed for private insurance within all national systems; exceptions to fee schedules in Australia, France, and Germany; and the complaint mechanism for malpractice in New South Wales.

White begins by describing each country's system and then follows with chapters disucssing three classes of problems. "Quality and Access" uses the experience of other countries to establish a reasonable baseline for what the U.S. should aim to achieve. "Collecting the Money" discusses who pays and how. "Controlling Costs" explains how other countries have moderated their cost increases.

The final chapter assesses American reform proposals in light of the foreign evidence. White argues that a synthesis of "competition" and "regulation" is possible and that such a synthesis is approached by the Clinton proposals. But he also identifies areas where those proposals fall short or risk collapsing of their own weight. He concludes by comparing the administration's proposals to the major alternatives.

"This book is serious scholarship at its best. Comprehensive in scope, insightful in character, and compelling in its reasoning, the book presents a balanced treatment of alternative proposals."—Choice

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Bibliographic data

Copyright year: 2010
ISBN-Print: 978-0-8157-9363-2
ISBN-Online: 978-0-8157-1437-8
Publisher: Rowman & Littlefield, Lanham
Language: English
Pages: 392
Product type: Book Titles

1. Contents No access
1. Learning from Others No access
2. Competing Solutions No access
3. Plan of the Book No access
1. 1. Defining Health Care No access
  2. Financing Health Care No access
  3. Delivering Health Care No access
  4. Conclusion No access
2. 1. How Americans Are Insured No access
  2. Delivering American Health Care No access
  3. Ensuring High-Quality Care No access
  4. Conclusion No access
3. 1. Canada No access
  2. Germany No access
  3. Summary: Germany and Canada No access
4. 1. Australia No access
  2. France No access
  3. Japan No access
  4. United Kingdom No access
5. 1. Performance Comparisons No access
  2. Choices within the International Standard No access
1. 1. The Attractions of Managed Competition No access
  2. Managed Competition as an Attempt to Leapfrog ahead of the Pack No access
  3. The Flaws in Managed Competition No access
  4. Competition within a Budget: The New NHS No access
  5. Conclusion: Finance and Delivery No access
2. 1. The Deficit and CBO No access
  2. Basic Issues and Structural Choices No access
  3. The Difficulty of Regulating Competition No access
  4. Managed Competition and Universal Coverage No access
  5. Wishful Thinking in Chafee and Cooper-Grandy No access
  6. Conclusion: The Difficulty of a Synthesis No access
3. 1. Clinton's Combination of Competition and Regulation No access
  2. Analysis of the Clinton Plan No access
  3. Beyond the Clinton Plan No access
4. 1. Why Reform Is So Difficult No access
  2. Meeting Reform Halfway? No access
  3. Getting It Right No access
  4. The Logic of Health Care Reform No access
1. Implementing a Cap on Tax Deductibility of Health Benefits No access
2. Financing Subsidies No access
3. Subsidy Administration in the Health Security Act No access
4. Administering a Cap on the "Weighted Average Premium" No access
Notes No access Pages 309 - 380
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3. C No access
4. D No access
5. E No access
6. F No access
7. G No access
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11. K No access
12. L No access
13. M No access
14. N No access
15. O No access
16. P No access
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18. R No access
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20. T No access
21. U No access
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23. W No access
24. Z No access