Competitive Reform in Health Care: The Vulnerable Revolution

Abstract

This article, written at the dawn of the era of "competitive reform" in health care examines the case and prospects for the introduction of competition in health care delivery and financing. It observes the failures of the ancienne regime of fee for service payment and professional sovereignty and discusses the benefits of market-oriented policy. Its contribution, still salient today, is the lesson that competition cannot succeed without regulation. It identifies legislative, professional, and cultural hurdles to effective implementation of competitive norms and policies that have impeded the success of competition policy in health care.

Keywords: antirust, health law, managed care, fee for service, hospital mergers, health care reform, FTC, physicians, competition policy, market failure