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Biomedical subjects

A Enthoven

Publications and source records attributed to A Enthoven.

At least 19 recordsLinked to original sources
PubMed1996

Responsible choices for achieving reform of the American health system.

"Responsible Choices" identifies the actions the private sector and government should take to improve the American health system and accelerate and expand the health care revolution that is already underway. Policy proposals are made for: Medicare; Medicaid; reforming the tax treatment of health insurance; insurance reforms and expanding group purchasing opportunities; and improving the availability of comparative information on health benefit offerings, quality accountability, and cost and coverage information. The recommendations refocus the Jackson Hole Group's original managed competition proposals contained in "The 21st Century American Health System" (1991).

Employee Retirement Income Security Act↗
PubMed1995

Is there convergence between Britain and the United States in the organisation of health services?. Interview by Penny Newman.

Is the organisation of health care in Britain becoming similar to that in the United States? Since the introduction of the internal market radical change has gripped the NHS. In the United States, despite the failure to implement coherent health care reform, a health care revolution is under way, driven by cost containment. At the centre of these changes is managed competition. Alain Enthoven, Marriner S Eccles professor of public and private management at Stanford University, has been the principal proponent of managed competition in both countries. His writings inspired the NHS reforms in 1989 and President Clinton's advisers to adopt managed competition in 1994, though ultimately he became opposed to the Clinton plan. In this interview with Penny Newman he redefines managed competition, explores the similarities and differences that have arisen between Britain and the United States, and describes recent trends in the United States, many of which are being mirrored in Britain. He illustrates a degree of convergence between the two countries. This was unthinkable 10 years ago when comparing the fee for service system in the United States with the NHS.

Competitive Medical Plans↗
PubMed1994

Health reform: what to expect from the coming debate. Interview by Jeannie Mankelker, Dan Wise, and Steven Findlay.

Health care reform is in limbo as 1994 draws to a close. Last month's Republican sweep puts the issue in a starkly new political environment. The new Congressional leadership said last month it will put forth a reform plan in 1995. Also, the Clinton administration is working on a scaled-back proposal. To get an idea of what might happen next year, we invited 20 informed persons to give us their opinions and to tell us what action they'd prefer. Because of B&H's production schedule, the interviews took place before the election. We don't think that diminishes their insights and analyses.

Forecasting↗
PubMed1993

Market reform and universal coverage: avoid market failure.

Determining the marketing mix for hospitals, especially those in transition, will require critical analysis to guard against market failure. Managed competition requires careful planning and awareness of pricing components in a free-market situation. Alain Enthoven, writing for the Jackson Hole Group, proposes establishment of a new national system of sponsor organizations--Health Insurance Purchasing Cooperatives--to function as a collective purchasing agent on behalf of small employers and individuals.

Commerce↗
PubMed1993

Achieving effective cost control in comprehensive health care reform. The Jackson Hole "managed care managed competition" approach.

The managed competition approach was originated by Alain Enthoven, a professor at the Stanford University Graduate School of Business, in the late 1970s, and has since been refined by Enthoven and a group of colleagues meeting in Jackson Hole, Wyoming. This outline was presented by Enthoven at hearings on cost control in health care reform held by Senator Edward Kennedy (D-MA) in December 1992.

Competitive Medical Plans↗
PubMed1989

A consumer-choice health plan for the 1990s. Universal health insurance in a system designed to promote quality and economy (2).

We describe the characteristics necessary for a plan for universal health insurance to find broad acceptance. Such a plan must represent incremental, not radical, change; must respect the preferences of voters, patients, and providers; must avoid major disruption in satisfactory existing arrangements; must avoid creating major windfall gains or losses; must avoid large-scale income redistribution; and must not be inflationary. Our proposal would create a framework that would encourage the efficient organization of care. Successful organizations would probably be those that attracted the loyalty and commitment of physicians, integrated insurance and the provision of care, and aligned the interests of doctors and patients toward high-quality, cost-effective care. The proposal's chief potential disadvantage would be its effect on the employment opportunities of low-wage workers, but this effect could be minimized. In addition, we discuss a proposal to mandate coverage by employers of full-time employees, legislation enacted recently in Massachusetts, high-risk pools, and the system followed in Canada, comparing each of these alternatives with our proposal.

Canada↗
PubMed1989

A consumer-choice health plan for the 1990s. Universal health insurance in a system designed to promote quality and economy (1).

America's health care economy is a paradox of excess and deprivation. We spend more than 11 percent of the gross national product on health care, yet roughly 35 million Americans have no financial protection from medical expenses. To an increasing degree, the present financing system is inflationary, unfair, and wasteful. In its place we need a strategy that addresses the whole system, offers financial protection from health care expenses to all, and promotes the development of economical financing and delivery arrangements. Such a strategy must be designed to be broadly acceptable in our society. To remedy the deprivation, we propose that everyone not covered by Medicare, Medicaid, or some other public program be enabled to buy affordable coverage, either through their employers or through a "public sponsor." To attack the excess, we propose a strategy of managed competition in which collective agents, called sponsors, such as the Health Care Financing Administration and large employers, contract with competing health plans and manage a process of informed cost-conscious consumer choice that rewards providers who deliver high-quality care economically.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1989

A new perspective on universal health insurance. Interview by Donald E.L. Johnson.

Stanford University professor Alain Enthoven and his associate Richard Kronick have developed a proposal for national, universal health insurance for Americans not covered by Medicare or Medicaid. The plan, published in the Jan. 5 and Jan. 12 editions of The New England Journal of Medicine, would mandate health insurance coverage for all workers. "Public sponsors," such as large employers and the Health Care Financing Administration, would be retained, to create agencies to buy group health insurance for the uninsured and for employees of firms too small to act as sponsors. In this interview with Donald E.L. Johnson, Health Care Strategic Management's editor and publisher, Enthoven discusses the plan.

Health Benefit Plans, Employee↗
PubMed1988

Managed competition of alternative delivery systems.

The markets for health insurance and health care are not naturally competitive: they are susceptible to many forms of market failure. Health plans and consumers may use strategies that lead to inequity and inefficiency. But experience with successful models of competition suggests that tools are available to enable sponsors (active collective agents on the demand side who contract with health plans to structure and manage competition) to use competition to achieve a reasonable degree of efficiency and equity for their sponsored populations. All this implies a more complex, dynamic, and sophisticated view of competition than one usually finds in apologia for free markets. A free market is not possible in health insurance.

Community Participation↗