Prologue: David Stockman became a national phenomenon when he emerged, shortly after Ronald Reagan's election, as the most visible figure ever to hold the directorship of the powerful Office of Management and Budget. Brash and brilliant, Stockman gained further notoriety through a recent Atlantic Monthly article that detailed where he thinks administration policies will lead the nation and what steps must be taken to get there. His vision, like that of President Reagan, features economic growth through reduced taxes, less government, and a strong military. But in the health field, Stockman is far out in front of other members of the administration in his commitment to a new prescription to transform the nation's third largest industry along lines that reflect the presidents strong belief in competition, free enterprise, and the private sector. Stockman holds that position by virtue of the substantial time and serious thought he devoted to the subject while a member of Congress. His strong commitment to this set of ideas led to his cosponsorship of the National Health Care Reform Act of 1981 with Rep. Richard A. Gephardt (D-Mo.). Shortly after Mr. Reagan won the 1980 presidential election and before Stockman resigned his Michigan congressional seat to become director of OMB, he set out his views on health care during a conference at Project HOPE. His remarks there remain the most unvarnished public articulation of the premises upon which he bases the need to create a health competition model in the United States. His premises called for franchising consumers, redistributing income in a form of fixed and controllable monetary subsidies, placing at financial risk those who purchase new technology and construct medical facilities, structuring provider competition, marketing health care on a retail basis, and creating a self-organizing provider market.
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David A. Stockman (1981) studied this question.