U.S. Health-Care System Changes Proceed In Absence Of Reform

Industrial and academic biomedical scientists are increasingly affected by 'competition without the management end' But regardless of their position on the issue, research administrators in industry and academia agree that the United States health-care market is already driving the system toward reform, even without legislation. And in the two years since Bill Clinton became president, they say, these market-influenced changes have

Barbara Spector

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Industrial and academic biomedical scientists are increasingly affected by 'competition without the management end'

But regardless of their position on the issue, research administrators in industry and academia agree that the United States health-care market is already driving the system toward reform, even without legislation. And in the two years since Bill Clinton became president, they say, these market-influenced changes have dramatically altered the way virtually everyone in this sector does business.

"The market forces are out there, which are pushing toward the managed competition [and] the HMOs," observes Bruce L.R. Smith, a science-policy analyst at the Washington, D.C.based Brookings Institution. "The whole Clinton health [plan] was more a reflection of those forces than the cause of the debate. And those forces will continue, and they'll have some impact."

"Though we didn't make any policy headway, the market has changed phenomenally in the past 22 months," reports Edward O'Neil, an ...

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