"Procompetition" and the continuing struggle to contain health-care costs

Various proposals designed to increase competitive forces in the health-care services economy are discussed. Two concepts inherent in market-oriented strategies for containing health-care costs--cost sharing and fixed-dollar subsidies--are defined. Among the strategies for increasing market forces in health care are (1) increasing consumer choice, (2) increasing consumer cost sharing, (3) modifying tax treatment of insurance and medical care, (4) controlling the terms of employment-based insurance, and (5) application of antitrust law. Specific conceptual and legislative "procompetition" proposals are summarized. All of the "procompetition" proposals offer economic incentives for good management of hospitals as a whole as well as for individual departments such as the pharmacy.