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Merging managed care with the German model
Author(s) -
Weil Thomas P.
Publication year - 1997
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/(sici)1099-1751(199704)12:2<115::aid-hpm462>3.0.co;2-w
Subject(s) - medicaid , business , reimbursement , managed care , payroll , german , health care , legislature , state (computer science) , public administration , public relations , economic growth , economics , political science , accounting , archaeology , algorithm , computer science , law , history
Since public officials in the United States may lack the courage and political will to significantly raise payroll taxes or to constrain Social Security, Medicare and Medicaid benefits, Americans can anticipate that: (a) future generations increasingly will pay for these entitlements; (b) additional cutbacks to providers in Medicare, Medicaid and health maintenance organization reimbursement will hasten the current thrust of hospitals, physicians and insurers in forming hugh health networks with their powerful managed care plans; and, (c) many of these new alliances will function as virtual monopolies—eventually resulting in the public proposing that state health services commissions be established. This article then suggests that future modifications in how the United States health delivery system be organized and financed preferably should be along the lines of the German multi‐player, multi‐tier, self‐governing, decentralized, quasi‐private, quasi‐public model; and, also patterned after the experiences of the State of Arizona's Medicaid program. It concludes that what America needs most is a hybrid of the European global budgetary targets to constrain total health expenditures, and the competitive managed care concept to curtail use patterns and to enhance quality. © 1997 John Wiley & Sons, Ltd.