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PubMed1981

Individual health accounts: an alternative health care financing approach.

After examining the major determinants of inefficiency in health care markets and several recent proposals to correct these problems, this paper introduces a market-oriented alternative which could be highly efficient while meeting all the established goals of a national health plan. To achieve these objectives, traditional forms of insurance would be replaced by a system with the following characteristics: (1) instead of buying insurance, individuals and their employers would be required to contribute into individual health accounts from which each family would pay for medical care; (2) Once accumulations attain a designated level, any excess accumulations are distributed to the individual; and (3) A national health fund is established to support those without regular accumulations or those whose accounts have been depleted. This paper develops these principles to show how everyone would have access to care as well as the financial security normally associated with comprehensive insurance. But, by inducing many patients to behave as if they were paying for the full cost of care through reductions in potential earnings from their accounts, the paper explains how significant savings in total spending could also be achieved.

Community Participation↗
PubMedDate not supplied

DRGs are not the answer.

With almost a $400 billion price tag for medical services rendered in 1984 and annual spending levels increasing at double-digit rates, changes in the financing mechanism for medical care services were unavoidable. The passage of the Tax Equity and Fiscal Responsibility Act ushered in an era of prospective payment for hospitals, and in 1984 total healthcare spending in the United States increased by 9.1%. The medical price component of the consumer price index rose 6.2%. Although these annual increases are improvements over previous years' data, the author's contention is that significant and greater savings can be realized by restructuring several elements of the healthcare environment rather than concentrating efforts solely on reshaping the payment mechanism for the hospital industry.

Diagnosis-Related Groups↗
PubMedDate not supplied

Health care enters the real world.

The U.S. health care system is undergoing restructuring as a result of a complex interplay of social, political, and economic forces. Where once the medical profession had a monopoly position in the health care system, its position has been challenged by the Federal Trade Commission under the Sherman Antitrust Act. More and more, the health care field is characterized by entrepreneurialism, a concept that is at odds with the traditional tenets of the medical profession. The restructuring of health care in the U.S. has the potential to allow the entrepreneur to function to the benefit of patients, despite the fact that this is a change resisted by those providing health care services.

Delivery of Health Care↗
PubMedDate not supplied

Physician fee-setting requires scrutiny.

To avoid antitrust liability from physician fee-setting in HMOs and PPOs, participating physicians should share the risk of profit and loss. "Health Law" is a regular feature of Physician Executive contributed by the law firm of Epstein Becker and Green, P.C. Douglas A. Hastings, Esq., a partner in the firm's Washington, D.C., offices serves as column editor.

Delivery of Health Care↗
PubMed1988

Antitrust ace.

Explore the source record for details and available documents.

Economic Competition↗