Sources: Department of Health and Human Services (Health Care Financing Administration) and Employee Benefits Research Institute.

Clearly, no plan for health-care reform is without its pluses and minuses, costs and benefits. Although managed competition would encourage rivalry among health insurers providing a basic benefit package, the government would become responsible for defining the benefits that most Americans would receive. On the other hand, play-or-pay proposals would improve access to insurance by mandating employer coverage, but they do not address the problem of rising medical costs and may cause firms to lay off low-wage workers. National health insurance proposals would provide insurance for all Americans but could lead to a cost explosion. Reforms that give consumers, insurers, and providers appropriate incentives are likely to be most effective in controlling costs, improving access, and giving consumers the quality of health care that they want.

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