The terms of the unfolding debate over Clinton s health care proposal have been set by the administration within the framework of so-called managed competition. The complexity of the plan guarantees extended discussion and endless amendment. But so far most single-payer advocates have avoided the question of whether Clinton s plan should be supported or opposed. Single-payer critics have denounced the Clinton plan, calling it a cruel hoax.
Insurance companies are a central component of the U.S. health care problem.
Yet Clinton s plan would further empower the insurance monoliths, and rely on them to serve as the agents of his solution. Most critically, the Clinton program puts patients at the mercy of insurance carriers, who are required to control health care costs, but are given no way to effectively limit costs except through denial of medical care. The plan would transform most health insurance enrollment from a group basis to individual choice. Competition for subscribers would supposedly ensure fair and responsive treatment by the insurance companies. But the opposite will more frequently be the case.