Will Competition in Health Care Work Without Budget Constraints?Posted: August 22, 2012 Filed under: Columns, Health and Health Policy, Taxes and Budget 13 Comments »
In a recent column I asked how the health sector might respond to an increased demand for health care if it were subject to normal competitive pressures. I particularly took issue with whether there was a doctor shortage or a broader misallocation of resources and noted that the lack of competition in the health care market is a major reason prices are so high.
Given the comments I received, I need to clarify one point: while I think we will see more competition in the future, it won’t arrive deus ex machina. It can and should accompany real reform that slows the growth of health costs.
These competitive forces aren’t ever going to come into play without budget constraints in government health programs. Interestingly, a budget constraint is an important component of almost all major reforms, whether it involves premium support or Medicare for all.
I reached a similar conclusion after reading a CBO report a few months ago. CBO examined 10 major Medicare demonstrations aimed at enhancing the quality of health care and improving the efficiency of health care delivery and found that most of these programs have not reduced Medicare spending. It wasn’t that the incentives in those experiments were bad ideas as much as they often weren’t designed in any way to prevent savings leaking out somewhere else. More services or higher prices elsewhere can easily offset some particular efficiency improvement.
Consider also why CBO wouldn’t give the Obama administration the saving it wanted to be scored for experiments authorized in 2010 health reform. In his new book on the budget, Wall Street Journal editor David Wessel notes this disagreement between OMB director Peter Orszag and CBO director Douglas Elmendorf. The administration’s experiments had no real budget constraints that would lead health providers to respond to the incentives to provide more for less.
But don’t misunderstand. With budget constraints, some experimental efforts are much more likely to succeed; indeed, that’s the nature of competition. Successes are also imitated. Then we move from win-lose to win-win, with potentially large compounding effects on reducing the rate of growth of health costs.
I’m extremely impressed ѡith ʏоur writing skills ɑs
weⅼl аs ᴡith the layout оn your blog.
Is this a paid theme oг did yⲟu modify it yօurself? Εither way keep up thе nice quality writing, it’s rare to seе
a great blog ⅼike tҺis one tⲟdɑy.
For іnstance, notice the frequent use of such terms aѕ human capitɑl, subordinate, rank and file, and headcount – terms
which connⲟte pгoperty, servitude or point-ness.
Writing articles for client companies is called SEO
web page. For this big and small business houses need an online presence.
Many people want to learn it, so as to promote their product
or their online store.
Qualifications decide how talented your attorney is. Minors have
until their 20th birthday to properly file and properly serve a Complaint or Writ of
Summons against all responsible parties. Every tort claim,
regardless of its basis, whether intentional, negligence, or strict liability, has two basic
These specialties include cosmetic dentistry, sedation dentistry,
TMJ – neuromuscular dentistry, orthodontics, general dentistry,
or a family dentist. The dental specialists practicing cosmetic
dentistry are called prosthodontists and orthodontists.
Only three procedures of cosmetic dentistry mentioned above.
Hello to all, the contents existing at this website
are in fact remarkable for people experience, well, keep up the good work fellows.
We are on the lookout for franhhisee of our products in are aan esteemed group that’s engaged in offering Pharma Franchise.
I believe this is among the so much vital information for me.
And i am satisfied studying your article. But want to observation on some
common issues, The web site style is great, the articles is in point of fact great :
D. Good process, cheers
Hi there, just became aware of your blog through Google, and
found that it’s really informative. I’m gonna watch out for brussels.
I’ll appreciate if you continue this in future. Many
people will be benefited from your writing. Cheers!
Unique digital provides san, nas, iscsi, dr solutions for customers
insuring better utilization and greater reliability.
Superb, what a web site it is! This weblog ppresents useful data to us, keep
Thanks , I’ve just been looking for info approximately this subject for a long time and
yours is the best I have came upon till now. However, what about the conclusion? Are
you certain in regards to the source?
What a stufff of un-ambiguity and preservenes of precious experience about unpredictted emotions.