《COMPETING SOLUTIONS AMERICAN HEALTH CARE PROPOSALS AND INTERNATIONAL EXPERIENCE》

1. Introduction: Health Care Choices1

Learning from Others1

Competing Solutions4

Plan of the Book10

Part One: American Health Care and the International Standard13

2. Challenges and Choices for American Health Care15

Defining Health20

Financing Health Care23

Delivering Health Care30

Conclusion34

3. The American Health Care System36

How Americans Are Insured36

Delivering American Health Care49

Ensuring High-Quality Care55

Conclusion59

4. Canada and Germany: The Two Most Common Models61

Canada61

Germany72

Summary: Germany and Canada88

5. Alternatives: Australia, France, Japan, and the United Kingdom91

Australia91

France103

Japan112

United Kingdom121

6. Twentieth-Century Health Care Systems128

Performance Comparisons128

Choices within the International Standard155

Part Two: Competing Solutions163

7. The Theory of Managed Competition165

The Attractions of Managed Competition166

Managed Competition as an Attempt to Leapfrog ahead of the Pack169

The Flaws in Managed Competition172

Competition within a Budget: The New NHS186

Conclusion: Finance and Delivery196

8. Drafting Managed Competition199

The Deficit and CBO200

Basic Issues and Structural Choices202

The Difficulty of Regulating Competition207

Managed Competition and Universal Coverage211

Wishful Thinking in Chafee and Cooper-Grandy217

Conclusion: The Difficulty of a Synthesis220

9. The Clinton Plan: Managed Competition with a Global Budget223

Clinton's Combination of Competition and Regulation225

Analysis of the Clinton Plan237

Beyond the Clinton Plan249

10.Health Care Reform in America251

Why Reform Is So Difficult251

Meeting Reform Halfway?260

Getting It Right269

The Logic of Health Care Reform290

Appendix: Technical Aspects of Managed Competition292

Implementing a Cap on Tax Deductibility of Health Benefits292

Financing Subsides297

Subsidy Administration in the Health Security Act300

Administering a Cap on the "Weighted Average Premium"303

Notes309

Index381