ABSTRACT
Health services in the United States are, for the most part, not organized on the basis of economic competition in the usual sense of that term. Medicare, Medicald, and many Blue Cross plans pay on the basis of cost reimbursement which rewards hospitals for generating more costs. The great majority of Americans are insured through Medicare if they are aged or disabled, through Medicald if they are poor and fit a category that is covered, or through an employer-provided health insurance plan. The tax exclusion has put the control of health benefits under employers or, where there are unions, jointly under the control of labor and management. In the full version of Consumer-Choice Health Plan, the tax credit would equal 60 percent of the actuarial cost for covered services for people in each demographic category. The medical profession traditionally has opposed economic competition in health care services.
