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Canada-style health coverage endorsed

A leading U.S. medical journal urges adoption of Canadian-style national health insurance, arguing that the Clinton administration's proposed managed competition will fail.

"In my view, it is highly doubtful that managed competition would contain costs while maintaining quality," Dr. Marcia Angell, the New England Journal of Medicine's executive editor, wrote in an editorial in today's edition.

Under managed competition, which Angell said President Clinton seems to be favoring, health insurance would be sold by huge, government-created cooperatives.

Angell suggested these plans might collude to raise prices instead of competing to lower them. And if they did compete, they could do so by stinting on services. Furthermore, this approach would add another layer of bureaucracy to oversee the system.

Instead, the journal proposed "a Canadian-style single-payer system to fund the delivery of health care," which it argued would be more efficient.

In Canada, provincial governments provide health care to everyone. They control costs in part by limiting the number of hospital beds and the spread of new technology. Critics complain of long waits for routine procedures and tests.

By limiting spending and ending price competition "we might for the first time really get our money's worth," Angell said. "And since we are spending far more per citizen than any other country, that would mean Americans would have the very best medical care in the world."