Where Should The Buck Stop: Federal And State Responsibilities In Health Care Financing Reform

Surrounding the discussion of managed competition and its innovative model, health insurance purchasing cooperatives (HIPCs), are a number of issues relating to specific facets of health care financing and delivery. This set of Perspectives examines some of those issues. First, Richard Kronick addresses the division of responsibility between the federal government and states for designing and administering HIPCs. Next, Linda Bergthold describes possible benefit packages. Alan Hillman and colleagues discuss quality of care, focusing on the implications for quality if a new delivery model were adopted. Finally, Mark Schlesinger and David Mechanic highlight the needs of the chronically ill, especially those with chronic mental illness, and how best to meet those needs under managed competition. These papers were presented at “Choice Alternatives: Strategies for Universal Health Insurance and Managed Competition,” 20-22 November 1992, in Princeton, New Jersey.