The Decline and Fall of Deregulation

Hopes for a price-competitive, deregulated health economy are fading as the end of Ronald Reagan's second term approaches. The current output of professional health care journals includes a declining quotient of articles by authors who are true believers in either the desirability or the likelihood of such an outcome. Alain Enthoven, one of the most thoughtful free-marketplace proponents, now writes about, "managed competition" and says, "A great deal remains to be done to achieve the goals envisioned by the pro-competitive reformers."1 Among health providers, with whom the marketplace strategy of cost control has achieved a high level of popularity, a . . .