Cain H P
Health Aff (Millwood). 1999 Jul-Aug;18(4):25-39. doi: 10.1377/hlthaff.18.4.25.
Transforming Medicare into a Federal Employees Health Benefits Program (FEHBP)-type program holds the promise of more choice, lower costs (in the long term), and higher quality--a fine concept that will collapse in its implementation unless at least three conditions are met. (1) Congress gets the regulatory structure right and then refrains from annual tinkering, (2) Congress does not set unrealistic expectations regarding "cost savings," especially if a prescription drug benefit is added, and (3) administrative agency staff have the requisite training and a "privatizing" orientation. Given Medicare's history and the "Medicare-industrial complex," none of those conditions is likely to be met.
将医疗保险转变为联邦雇员健康福利计划（FEHBP）类型的项目有望带来更多选择、更低成本（从长期来看）和更高质量——这是一个很好的概念，但除非至少满足三个条件，否则在实施过程中将会失败。（1）国会建立正确的监管结构，然后避免每年进行修修补补；（2）国会不对“成本节约”抱有不切实际的期望，特别是在增加处方药福利的情况下；（3）行政机构工作人员具备必要的培训和“私有化”倾向。鉴于医疗保险的历史以及“医疗保险产业综合体”，这些条件无一可能得到满足。
