ISSUES EVERY PLAN TO REFORM HEALTH-CARE FINANCING MUST CONFRONT

This paper focuses on three main issues of fundamental health care reform. First, should experience rating-the linkage of premiums to actual loss experience-be retained? Despite widespread support for experience rating among economists, the paper argues that it should be abandoned for reasons of efficiency and equity. Second, would abandonment of experience rating cause much redistribution? The paper shows that redistribution among industries could require significant transitional adjustments. Third, should companies or individuals be subject to an insurance mandate? The paper calls for combining individual mandates, which have long-term advantages, with employer mandates, which have short-run pluses.