Economy
Related: About this forumWould Americans Accept Putting Health Care on a Budget?
The intuitive appeal of such a system is growing, and its getting a test in Maryland.
'If you wanted to get control of your household spending, youd set a budget and spend no more than it allowed. You might wonder why we dont just do the same for spending on American health care.
Though government budgets are different from household budgets, the idea of putting a firm limit on health care spending is far from unknown. Many countries, including Canada, Switzerland and Britain, pay hospitals entirely or partly this way.
Under such a capped system, called global budgeting, a hospital has an incentive to deliver less care including reducing hospital admissions and to increase the efficiency of the care it does deliver.
Capping hospital spending raises concerns about harming quality and access. On these grounds, hospital executives and patient advocates might strongly resist spending constraints in the United States.
And yet some American hospitals and health systems already operate this way, including Kaiser Permanente and the Veterans Health Administration. To address concerns about access and quality, these programs are usually paired with quality monitoring and improvement initiatives.
That brings us to Marylands experience with a capped system. The evidence from the state is far from conclusive, but this is a weighty and much-watched experiment for health researchers, so its worth diving into the details of the latest studies.
Starting in 2010 with eight rural hospitals, and expanding its plan in 2014 to the states other hospitals, Maryland set global budgets for hospital inpatient and outpatient services, as well as emergency department care. Each hospitals budget is based on its past revenue and encompasses all payers for care, including Medicare, Medicaid and commercial market insurance. Budgets for hospitals are updated every year to ensure that their spending grows more slowly than the states economy.'>>>
https://www.nytimes.com/2018/04/16/upshot/would-americans-accept-putting-health-care-on-a-budget.html?
Hoyt
(54,770 posts)Last edited Tue Apr 17, 2018, 09:58 AM - Edit history (1)
viable way forward. Well get there fastest by a public option that ultimately leads to close to single payer.
But some people arent going to get the ultimate in care because the small benefits arent worth the cost to the system designed to take care of the masses. Wealthy are going to pay more in taxes, too bad. Some providers, pharmaceutical companies, device manufacturers, etc., are going to have to take less. Again, too bad.
Theres more, but our system is going to implode, if it hasnt already, and all people getting decent care is better than too many people getting no care.
Voltaire2
(13,075 posts)out of the system first, rather than reducing services. Or is that too much to ask our elite billionaires to sacrifice?