Health Care Reform: The Good, the Bad, and the Ugly

November 24, 1992 • Policy Analysis No. 184

While Congress has actually taken little action on health care reform, there has been no shortage of discussion on Capitol Hill. This year alone Congress has considered more than 100 bills on health care that range from two pages to more than 200 pages. In addition, the Bush administration released a 94‐​page outline of its health care reform program. President‐​elect Bill Clinton also has a health care plan. And nearly every think tank with a word processor has contributed a proposal as well.

Those proposals run the gamut–from good to bad to ugly. The ideas receiving the most discussion in the media are those that would increase the involvement of government in health care. That first group of proposals is focused on methods of financing expanded access to health insurance. They generally take one of two approaches: (1) a universal, single‐​payer, government‐​operated, tax‐​funded system or (2) a “play or pay” system, built around a mandate on employers. The second set of proposals attempts to accomplish the same goals without spending more money. Those proposals often focus on regulatory manipulation of the insurance industry. Most other proposals would change the behavior of health care consumers, generally through some form of tax incentive.

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