Financement privé et réglementation : l'expérience du système de santé des États-Unis
By: BRECHER, Charles
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ArticlePublisher: Paris : IIAP, juil./sept. 1987Revue Française D'Administration Publique 43, p. 137-150Abstract: The United States health care systems is distinguished by a relatively large share of expenditures made in private sector. However, despite some popular beliefs, this large role for private financing has not been associated with freedom from regulation. Private purchasers of care, including business and unions, are increasingly concerned with controlling costs. This has transformed the private health insurance industry from a system whose major purpose was to raise revenues for hospitals to one whose principal product is an ability to control medical care utilization by monitoring and regulating physicians behavior. Abstract: This change in the indsutry is related to four trends - the use of experience rating, the participation of private firms in government programs, the growth of self-insurance, and vertical integration of insurers and providers. In addition, the recent substantial increase in the supply of physicians has weakened the previously strong political and economic position of the medical professional and made doctors more vulnerable to competitive pressures
The United States health care systems is distinguished by a relatively large share of expenditures made in private sector. However, despite some popular beliefs, this large role for private financing has not been associated with freedom from regulation. Private purchasers of care, including business and unions, are increasingly concerned with controlling costs. This has transformed the private health insurance industry from a system whose major purpose was to raise revenues for hospitals to one whose principal product is an ability to control medical care utilization by monitoring and regulating physicians behavior.
This change in the indsutry is related to four trends - the use of experience rating, the participation of private firms in government programs, the growth of self-insurance, and vertical integration of insurers and providers. In addition, the recent substantial increase in the supply of physicians has weakened the previously strong political and economic position of the medical professional and made doctors more vulnerable to competitive pressures
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