CLINTONITES SAY their proposed regional "health alliances" will be low-key, service-oriented facilitators of a new, reformed health-insurance market. Alliances will enroll consumers, give them their choice of health plans, collect premiums from employers and households, and distribute the funds with "a minimum of bureaucracy and expense," says White House health aide Walter Zelman. The Administration insists that alliances won't mean a government takeover of health care.
IN REALITY, a close look at Bill Clinton's alliances reveals all the signs of giant, politicized bureaucracies. The Congressional Budget Office--no foe of Big Government--lists these roles for the alliances: "purchasing agents, contract negotiators, welfare agencies, financial intermediaries"--and on and on. The alliances will command funds rivaling most state budgets, so governors and legislators will want to maintain control over them. The CBO does say the Clinton plan will achieve universal health coverage and eventually slow medical spending--but makes it clear that the price will be a health system dictated by governmentEDITED BY LARRY LIGHT AND JULIE TILSNER Mike McNamee