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May 19, 1993

Grading President Clinton's Health Proposal

Author Affiliations

From the Department of Economics, Princeton University, Princeton, NJ.

JAMA. 1993;269(19):2553. doi:10.1001/jama.1993.03500190097044

MAY IS that otherwise lovely month when American college professors are buried under mountains of examinations, papers, and dissertations, each waiting to be read and graded. This year, for some of us, the month of May will bring an extra assignment: Bill and Hillary Clinton's weighty tome on health care reform, coauthored by them, with the assistance of Ira Magaziner and some 500 additional miniauthors known in the trade as The Task Force.

The tome is likely to span dozens of chapters and hundreds of pages, but these can be organized into three parts, reflecting the conventional three goals of health care reform: better cost control, better quality control, and universal health insurance coverage.

To assign the proposal an overall grade one should, first, grade each part separately and then collapse the three scores into an overall weighted average grade, where the weight assigned to each part represents the relative