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Thomas Rice, PhD; E. Richard Brown, PhD; Roberta Wyn, MPH

JAMA. 1993;270(11):1357-1362.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

MANAGED competition is synonymous with market-oriented health care reform. Those who coined the phrase, the Jackson Hole Group,¹ have been identified, incorrectly, by the New York Times² as the brain trust for the Clinton administration's reform proposal. Many medical industry groups have participated in developing the Jackson Hole version of managed competition, including major insurance companies, the American Medical Association, the Pharmaceutical Manufacturers Association, and large health maintenance organizations (HMOs). About the only significant interest groups that have not expressed support for the concept are those representing consumers. In this article, we critically assess the Jackson Hole Group's proposal to control health spending and provide access to quality health care.

Boiled down to its fundamentals, the Jackson Hole approach to managed competition requires three major changes in the US health insurance system. First, regional health insurance purchasing cooperatives (HIPCs) are formed to manage the marketplace for health care . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Health Services (Drs Rice and Wyn) and Community Health Sciences (Dr Brown), UCLA School of Public Health, Los Angeles, Calif.

Footnotes
Reprint requests to Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90024-1772 (Dr Rice).

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