Abstract
I N JANUARY 1983, THE REAGAN ADMINISTRATION SENT to Congress a package of health care financing reforms. These proposals included a limit on the amount of tax-free employer contributions to health insurance and a Medicare voucher system. Underlying the Reagan plan was a market-oriented philosophy for financing health care services and controlling health care costs that has been called the competitive approach. The historical antecedents to this strategy can be found in the writings of Alain Enthoven and Walter McClure, and in prior congressional initiatives such as the Gephardt-Stockman bill (H.R. 7527). A common theme of these
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