The debate about health care is more than a question of whether the marketplace or government should shape the kind of care people receive. It's also about what kind of nation we want to be. There are 30 million people in the U.S. who are uncovered by any health plan, while many Americans can afford the best health care in the world. The lack of equal access to health care is unacceptable. A broad health care plan that assures all Americans of adequate access would be a powerful unifying force in a diverse society.
The business week proposal, a variation on the "managed competition" theme first advanced by Stanford University's Alain C. Enthoven, would salve some of the wounds created by our society's yawning inequality in income distribution. It would make sure that everyone has access to quality health care, that no one is allowed to fall through the cracks. Managed competition holds out the promise of preserving the best of a market economy and government guidance. It would rely on the market to provide some choice to consumers while letting the government set standards of care. It would enhance competition by equipping insurance buyers, especially small businesses, with the clout to bargain effectively with medical providers to keep health care costs down. Virtually every other industrialized country has some form of universal health insurance. Why not us?
Pressure for reform is growing daily. The public wants it. Business wants it. Even many doctors want it. Politicians planning on running in 1992 had better take note.