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Journal of Health Politics, Policy and Law 2003 28(2-3):341-354; DOI:10.1215/03616878-28-2-3-341
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Duke University Press

Part 2—The Private Sector: A New Industry?

The Politics of Managed Competition: Public Abuse of the Private Interest

James C. Robinson
University of California, Berkeley

Abstract.

The doctrine of managed competition in health care sought to achieve the social goals of access and efficiency using market incentives and consumer choice rather than governmental regulation and public administration. In retrospect, it demanded too much from both the public and the private sectors. Rather than develop choice-supporting rules and institutions, the public sector has promoted process regulation and benefit mandates. The private health insurance sector has pursued short-term profitability rather than cooperate in the development of fair competition and informed consumer choice. Purchasers have subsidized inefficient insurance designs in order to exploit tax and regulatory loopholes and to retain an image of corporate paternalism. America's health care system suffers from the public abuse of private interests and the private abuse of the public interest.


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V. Gray, D. Lowery, and E. K. Godwin
The Political Management of Managed Care: Explaining Variations in State Health Maintenance Organization Regulations
Journal of Health Politics Policy and Law, June 1, 2007; 32(3): 457 - 495.
[Abstract] [PDF]




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