Two Visions for Market-Based Health-Care Reform
“The architects of the managed competition framework — Alain Enthoven and Paul Ellwood — based their reform ideas on the promotion of fully integrated health plans. In this model, consumers don’t shop for individual medical services. Rather, they select a health plan that provides both their insurance coverage and an organized system of care delivery. It is up to the health plan, not the consumer, to find the most efficient ways of providing needed services to patients. The consumer’s role is to select from among the competing health plans based on the premiums they charge for coverage and quantifiable measures of their quality. HMOs that can offer high-quality care while also charging a low premium should be able to prosper in the managed competition reform model.”