In the late 1980s, the United States embarked on a great health- care experiment -indifferently planned and market-driven.

If it had a mother or a father, they were the nation's employers, who were sick of paying ever-increasing costs of employees' health care. It postulated that if the nation's physicians could only be herded and bullied into managed-care plans and HMOs, cost would be controlled and the alarming growth in the number of uninsured families would be halted, all without government's heavy hand to guide things. Affordable health care for everybody would be an attainable reality without switching to the dreaded but attractive Canadian model. So what if the harmless Canadians have longer life expectancies than Americans? Their system is socialistic and, need we say, un-American.

Well, the results of this experiment are in. And it looks to be a case of a brilliant tactical success that was a miserable strategic failure.

It succeeded in putting American doctors under a system of suffocating controls that may cause them to envy their Canadian counterparts. About 92 percent of American doctors participate in managed care. Physician fees, which had been rising more than 7 percent a year, are now going up about half as fast.

And the median income of physicians, which rose dramatically in the 1970s and 1980s and seemed headed for $200,000 a year in the 1990s, is declining. The American Medical Association's just released annual survey showed the median income of doctors was down for the fourth straight year in 1997, falling to $164,000. It was based on a telephone survey of 4,000 physicians.

The experiment succeeded only if you bought into the rubbish that greedy doctors were all that were wrong with the health-care system, that they needed MBAs and accountants to tell them how to practice medicine and that reducing their incomes, when everyone else's were rising, was a good way to make them more caring and attentive to patients.

We also have fairly conclusive evidence of just how these trends have affected the overall availability and affordability of health care: not favorably.

While the doctors were getting squeezed, the number of uninsured Americans rose steadily. They stood at 31 million in 1987. They now number about 43 million. Employers, meanwhile, are shifting a greater burden onto their workers. Employees on average now pay about 20 percent of their premiums, up from 10 percent 10 years ago. This accelerates pressure for more workers to
forgo coverage.

For a brief period early in this decade, it looked as if managed care was making a huge dent in medical-care inflation, largely at the doctors' expense. Health-insurance premiums were miraculously stable. But now premiums are going through the roof again, threatening to rise at two, three, even four times the overall rate of inflation.

Premiums rose 6 percent last year and are expected to rise 9 percent this year. Ominously, the second largest buyer of health insurance in the nation, the California Public Employees Retirement System, has just announced its rates will rise an average of 9.7 percent in 2000 for the 10 HMO plans it offers. Rates for its Kaiser Permanente plan will go up 11.7 percent.

The insurance industry whines that this is all because of patient- protection legislation passed in 39 states between 1994 and 1998. Well, even if they are right, it only tells us that the private insurance industry, with its relentless demands for profits and huge overhead costs, cannot deliver
affordable coverage at a standard that 39 states -and a great majority of voters -demand.

Experience tells us that premium increases will also boost the number of uninsured and the portion of premiums borne by workers. The breathing spell we had at the doctors' expense is over. The funny thing is, those asinine Harry and Louise TV ads, the ones sponsored by the Health Insurance Association of America that helped shoot down Hillary Rodham Clinton's health-care reform plan, were right in so many ways.

As the insurers warned, health-care choice has been restricted. Physician judgment has been curtailed. Patients and doctors are being herded like cattle. The number of uninsured has risen. And now premiums are taking off again. Hillary Clinton's health-care reforms never happened. But just about everything else did.

 ROBERT RENO writes for Newsday.