AUDREY R. CHAPMAN
Health Security Act
One of the major purposes of this volume is to develop human rights standards for formulating and evaluating proposals for health care reform. While a wide range of such proposals have been put forward, the Clinton's administration's Health Security Act is setting the agenda for debate and is likely to provide the framework for the restructuring of the health care sector. Therefore this chapter turns to the task of assessing the managed competition model as embodied in the text of the Health Security Act bill submitted to the 103rd Congress. To analyze the proposal from a human rights perspective, it will use the ten criteria identified in the earlier chapter, " A Human Rights Approach to Health Care Reform."
For a number of reasons the assessment in this chapter can only be considered, however, to be provisional. First, the Clinton administration's proposal is still evolving and key features are as yet unclear. At the time of writing, this author has reviewed three different versions of managed competition—" Health Security: Preliminary Plan Summary," 1 an official document made available shortly after President Bill Clinton's September address to the nation putting forward his proposal; a book entitled The President's Health Security Act published by The New York Times and described as "put out by The House Domestic Policy Council based on a test of The Working Group Draft dated September 7, 1993;" 2 and a 1342 page Health Security Act bill published in October, 1993. 3 There are likely to be further revisions as the bill passes through Congress. Moreover, any legislation that reconstructs the health care sector will need ongoing monitoring, with the flexibility to make further adjustments to be able to achieve its stated goals.