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Subject: Health Care Experts, Lawmakers Meet; 'Managed Competition' Advocated as New
Date: Fri, 6 Nov 92 05:06:14 EST
Message-ID: <39.1992Nov6.050614@AmeriCast.com>

Health Care Experts, Lawmakers Meet; 'Managed Competition' Advo-
cated as New Program Is Awaited<By Dana Priest<Washington Post
Staff Writer<

A small group of conservative Democratic lawmakers and like-
minded health experts, seeking a central role in what is expected
to be a burst of activity on health care legislation now that
Bill Clinton has been elected, have begun meetings to refine and
preempt attempts to co-opt Clinton's health care blueprint.  The
plan in question, which Clinton formerly adopted only late in the
campaign, has the obscure name of "managed competition" and is
the intellectual work of a group of health experts dubbed "The
Jackson Hole group," named for the location of their meetings, in
Jackson Hole, Wyo.

The group is highly regarded by academics and the health care in-
dustry. The Capitol Hill group, hoping some its cachet will rub
off on them, are calling themselves Jackson Hole East.

They held their first meeting last week and plan to meet once a
week at a restaurant behind the Cannon House Office Building.

The core group includes the most active House and Senate backers
of the Managed Competition Act, introduced last year by Rep. Jim
Cooper (D-Tenn.) and supported by the Congressional Democratic
Forum. They are Reps.  Michael A. Andrews (D-Tex.) and Charles W.
Stenholm (D-Tex.) and Sens. David L. Boren (D-Okla.) and John
Breaux (D-La.).

Outside members of the group include Richard Smith, director of
the Washington Business Group on Health, a national health policy
organization;  J. Mel Bass of Alcoa; and Jeremy Rosner, a health
policy expert at the Progressive Policy Institute, a conservative
Democratic think-tank positioned to play the same advisory role
to a Clinton administration that the Heritage Foundation played
to the Reagan administration.

The founders of the original Jackson Hole group, Stanford profes-
sor Alain Entoven, physician-turned-policy expert Paul Ellwood,
and health consultant Lynn Etheredge, also plan to meet with the
group and guide their discussions by phone and fax.

The goal of Jackson Hole East is to refine Cooper's legislation
so that its details are complete and defensible and therefore,
members hope, less susceptible to the outpouring of monied in-
terests - hospitals, insurers, doctors, and drug makers - that
are expected to launch attacks against any proposal that might
hurt their economic interests.

"We want these people in the group to do all the thinking," said
Caroline Chambers, Cooper's representative to Jackson Hole East.
"We really want the good, solid advice of the policy people."

The "managed competition" plan envisions all employees buying
health care from large HMO-like managed care networks that com-
pete against each other for consumers in a given geographical
area. A government board would set up nonprofit insurance pur-
chasing organizations in each state to bargain with networks for
the best rates. It would also establish a standard benefit pack-
age that all health networks must offer.

Data would be collected nationwide to allow consumers to judge
the quality of individual hospitals and doctors.

Jackson Hole East members are the true believers who think "the
private market weeds out inefficiencies much more brutally and
quickly" than government regulation, said Rosner, who called him-
self "a market-efficiency freak, a purist."

As "managed competition" has become the health policy buzzword of
the day, advocates of all political stripes have begun to take
the label for themselves.

"We have seen the term being thrown around all over the place,"
said Chambers. "We want to keep control of the definition."

Health policy experts predict that the biggest fights will come
over Clinton's proposal to set a ceiling on national health ex-
penditures. Managed competition purists, as well as industry in-
terests that might be threatened by limits on expenditures, op-
pose direct or indirect government price controls.

Paul Starr, a Princeton University sociology professor working on
ways to implement managed competition, will speak to the group
today. Karen Ignani, the AFL-CIO's chief health care policy ex-
pert, will hold a discussion with the members next week.<02:30
11-06C9999-----

Copyright 1992, The Washington Post.  This story is from the
Washington Post's Capitol Edition On-Line and is not to be ar-
chived or redistributed.

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