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It's the Prices, Advanced Capitalism, and the Need for Rate Setting - Stupid.

David M Frankford¹

¹David M. Frankford, J.D., is a Professor at Rutgers Law School; Professor at the Rutgers Institute for Health, Health Care Policy and Aging Research; and the faculty director at Camden of the Rutgers Center for State Health Policy. He has received his Bachelor of Arts degree in political science from Tufts University (Medford, MA) and also a Juris Doctor degree from the University of Chicago School of Law (Chicago, IL).

The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics

|June 30, 2017

Summary

Competition fails to control rising healthcare costs because it shifts responsibility to profit-driven institutions. The United States needs state rate setting to consolidate purchasing power and manage expenditures effectively.

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Area of Science:

Health economics
Public health policy
Healthcare systems analysis

Background:

Healthcare expenditures in the United States are rising unsustainably.
Market-based competition has been proposed as a solution but has proven ineffective.
The current system allows for demand generation by healthcare institutions.

Purpose of the Study:

To analyze why competition fails to control healthcare costs.
To propose an alternative policy for managing healthcare expenditures.
To advocate for state rate setting as a viable solution.

Main Methods:

Analysis of healthcare market dynamics and institutional incentives.
Economic evaluation of competition versus centralized purchasing power.
Policy analysis of state rate-setting mechanisms.

Main Results:

Competition diffuses accountability for rising costs.
Healthcare institutions, driven by advanced capitalism, excel at generating demand for services.
Concentrated purchasing power, unlike diffuse competition, can effectively counter cost escalation.

Conclusions:

Competition is an inadequate strategy for controlling healthcare expenditures.
State rate setting offers a mechanism to concentrate purchasing power.
Implementing state rate setting is recommended for the United States to manage healthcare costs.