Pamphlet from the vertical file.

These lectures review the research and experience on the subject of health care economy. The author also sets down a moderately rigorous statement of the economic concepts underlying the kind of competition that he regards as the most promising way to achieve a reasonable degree of equity and efficiency in health care. The first lecture is on the public policy goals of health care financing and delivery and discusses efficiency in health care. The second presents an economic analysis of the systems for organizing and financing medical care systems in the United States. The third lecture is about ``managed competition'', and the fourth reviews American experience with efforts to convert from the traditional system to a competitive system.The book is addressed primarily to economists, health policy makers and health services researchers. It explains how market forces may be managed in pursuit of equity and efficiency in health care. It addresses systematically many of the causes of market failure and proposes a strategy (``managed competition'') for overcoming them. It should be of interest to policy makers in any country interested in incentives for more efficient health care delivery. It should also be very useful supplemental reading for courses in health care economics.

The Congress is considering a range of alternatives for reforming the health care system. This study, requested by the Subcommittee on Health of the House Committee on Ways and Means, examines the potential of the managed competition approach to reduce the level and rate of growth of national health expenditures, and the specific features of managed competition that could generate significant savings. In keeping with the Congressional Budget Office's (CBO's) mandate to provide objective and impartial analysis, this study contains no recommendations.

And policy implications -- Applying government cost controls -- Effects of managed competition and HMO enrollment -- Effects of providing insurance to uninsured people -- Effects of administrative changes under reform.

The Telecommunications Act of 1996 envisioned a competitive free-for-all in the U.S. telecommunications industry with removal of barriers to entry in local telecommunications markets and the lifting of the artificial restrictions that kept the Regional Bell Operating Companies (RBOCs) out of the interLATA long-distance market. After close to 5 years, only one RBOC has been granted permission (controversially) to enter the interLATA market, and local competition has yet to provide most consumers with meaningful choices. In addition, the wave of mergers across the industry has raised the specter of putting the former Bell System back together again. Policymakers now openly question whether the Act can deliver what it promised. Three principal themes are developed in this book. First, there has been a coordination failure between Congress and the FCC in translating the principles embodied in the Act into practice. The authors provide evidence for this by analyzing stock market reactions to legislative and regulatory actions. This coordination failure was largely predictable, given the ambiguity in the Act, as well as conflicting jurisdictions between the FCC and the states. Second, the Act calls for wholesale prices to be `based on cost.' Regulators adopted a costing standard (TELRIC) that provides a means to subsidize competitive entry in local telephone service markets. The ready adoption of the TELRIC standard by regulators is shown to be tied to the third theme: price cap regulation provides regulators with `insurance' against the adverse effects of competition in local telephone markets. Statistical analysis reveals that regulators in price cap states set uniformly lower unbundled network element prices (lower barriers to entry) in comparison with regulators in rate-of-return and earnings sharing states. The result is a triumph of regulatory processes over market processes - the antithesis of the purpose of the Act.

The most important book on antitrust ever written. It shows how antitrust suits adversely affect the consumer by encouraging a costly form of protection for inefficient and uncompetitive small businesses.