TABLE 2-4 Medicare Legislation Report Card: The Clinton Administration's Proposal

Issue

Government Knows Best

Leave It to the Market

Government Policy Is to Correct Market Deficiencies

Benefits/plan type

X

 

 

Licensing

X

 

 

Enrollment

 

 

X

Consumer

 

 

 

Information

X

 

 

Purchasing style

X

 

 

Plan payments

X

 

 

Communications/ education strategy

 

X

 

Chronic care/ disclosure

 

X

 

Total (%)

50

25

25

vice, be fiscally solvent, and adhere to internal as well as external quality assurance requirements. Similarly, payments to plans are not based on competitive bidding or contracting, but continue to use government-set payments, based on modifications to the current AAPCC system and, in the case of the congressional legislation, based on further national per capita growth limits.46

With regard to purchasing style, both proposals support the FEHBP approach in which the federal government offers all plans that meet the conditions of participation and do not permit more selective and active purchasing based on performance, a strategy used by many employers to ensure accountability and value.

Both proposals would generally let the market prevail in the range of plan choices to be offered to beneficiaries. The Clinton administration's proposal, however, would not allow medical

46  

HCFA is currently testing a number of competitive pricing approaches under its demonstration authority.



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