1.   It is a monopoly with a little managed competition on the fringes.

2.   Managed competition, rather than a free Market in health care, is the leitmotif of the reforms.

3.   Experience so far of introducing managed competition into the NHS therefore has thrown up a number of political, normative and practical dilemmas.

4.   In conclusion, introducing managed competition into the NHS introduces a number of dilemmas, some of which admit no easy answer.

5.   As Steelman noted, there was a strong consensus among many health policy experts at the time that a form of managed competition was the way to go.

6.   Breaux seems an unlikely player in the Medicare debate, which tends to have its own wonky priesthood steeped in the arcane liturgy of managed competition.

7.   But Chairman Alain Enthoven shrugged off such claims, though he acknowledged he has a long track record as an advocate for managed competition in the health field.

8.   Earnhardt, being Earnhardt, did not much care for managed competition.

9.   He said he is encouraged by indications that modest attempts at managed competition in California have resulted in reduced insurance premiums.

10.   Many elements of managed competition were incorporated in the bill drafted by a bipartisan group of senators who called themselves the mainstream coalition.