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All payer
Background
editBackground
editIn the United States, Medicare pricing is transparent and based on a formula.[1] Health care prices for customers with private insurance, however, are determined by negotiations between the provider and the insurance (the payer).[2] These prices are not transparent, and they are treated as trade secrets.[1] The prices appear to be largely a function of the relative market power of each party and the negotiation itself.[1]
Uninsured patients can also be negotiate prices with providers.[3] The exact same service at the same facility can differ depending upon the payer (price discrimination).[1] For example,
Between any grouping of provider and payer, there is a distribution of market power. leverage to effect price raises, while if
Goals
editA goal of all payer is to increase the market power of payers.[4]
Reduce administrative costs
The White House's Fiscal Commission, led by Erskine Bowles and Alan Simpson, listed the idea of raising the eligibility age with the likes of such dramatic structural changes as the public option, block grants or an all-payer system[1]
Presence
editAll payer characteristics are found in the health systems in France, Germany, Japan, and the Netherlands.[4]
References
edit- ^ a b c d Uwe Reinhardt (November 26, 2010). "How Medicare Sets Hospital Prices: A Primer". The New York Times. Retrieved July 1, 2011.
- ^ Uwe E. Reinhardt (January–February 2006). "The pricing of U.S. hospital services: chaos behind a veil of secrecy". Health Aff (Millwood). 25 (1): 57–69. doi:10.1377/hlthaff.25.1.57. PMID 16403745.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: date format (link) - ^ M.B. Pell (April 20, 2011). "Huge hospital markups burden patients". The Atlanta Journal-Constitution. Retrieved July 1, 2011.
- ^ a b Joseph White (May 12, 2009). "Cost Control and Health Care Reform — The Case for All-Payer Regulation" (PDF). Retrieved June 29, 2011.