Market Forces, Competitive Strategies, and Health Care Regulation

In the following article, Professor William White examines the interaction between governmental and private efforts to reform the U.S. health care system. He begins by examining several distinctive features of the U.S. health care system. From there, Professor White provides a historical account of the modern U.S. health care system, focusing in particular on the post-World War II growth of private health insurance providers and the expanding government regulation of the health care industry. Tracking the shift away from regulatory efforts to “market-based,” competitive reforms in the 1980s, Professor White traces the rise of managed care in the 1990s and presents evidence of managed care’s failure to contain health care costs. Professor White concludes by examining some emerging trends in private insurance markets and government regulation of the health care industry, designed to slow the steady upward climb of health care spending.