ABSTRACT
Debate over health care "reform" is not new, but President Bill Clinton has demonstrated yet again the ability of the holder of the national bully pulpit to dominate Washington's political agenda. In order to cut spending, the Clinton program originally envisioned "global budgeting", whereby the National Health Board would impose maximum budgets on the Health Alliances (HA). The bureaucratic key to the administration's plan is the Health Alliances, which are to negotiate with providers and hold down insurance rates. Although considered to be part of the "managed competition" strategy advanced by many moderate Democratic supporters of the president, the HA's would be almost all management and no competition. Either monopoly government or quasi-government agencies, they would do nothing to spur market forces; rather, they would operate as yet an additional administrative layer on top of an already over-burdened system.
