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State health services commissions German style.

¹Bedford Health Associates, Inc., Asheville, NC, USA.

Hospital Topics

|October 1, 1995

Summary

Public demand for better healthcare access and cost control may lead to state commissions regulating health markets. A decentralized, multipayer German model offers more competition and less government oversight.

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Area of Science:

Health policy
Healthcare economics
Health services research

Background:

Health maintenance organizations (HMOs) can consolidate into oligopolies, compromising access, equity, and cost containment.
Public dissatisfaction with current healthcare systems necessitates exploring alternative regulatory and structural models.

Purpose of the Study:

To propose the establishment of state health services commissions to regulate healthcare markets.
To examine the German health system as a potential model for increased competition and reduced government regulation.

Main Methods:

Analysis of market dynamics within healthcare networks.
Comparative assessment of regulatory structures in different national health systems.

Main Results:

Oligopolistic organization of HMOs leads to inadequate access, social equity, and cost containment.
The German multipayer, decentralized system allows provider-insurer negotiation, fostering competition with less direct government control.

Conclusions:

State commissions are proposed to regulate market share, service scope, reimbursement, and profits.
The German model suggests a viable alternative for enhancing provider competition and minimizing government intervention in healthcare.

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