Insulating patients from the cost of health care: changes in the financing and regulation of health care in the past 50 years.
The evolution of the current financing of health care in the United States has been outlined. Although the decisions leading to the current system have been well intentioned, the result is a costly system in which many patients are left without health insurance coverage. Two methods of reconnecting patients to the cost of care are presented (tiered co-pays and MSAs), which may be acceptable to patients. We can only hope that, over time, these types of cost-sharing methods, combined with the evolution of other patient-centric, "evidence-based" models of care (such as identification and intensive case management of high-risk cases) may lead to a more efficient and affordable system of health care in the United States.
Permut
Stephen R
SR
Department of Family and Community Medicine, Temple University School of Medicine, USA.
D001294:Attitude to Health; D001364:Awareness; D017047:Cost Sharing; D003695:Delivery of Health Care / Q000191:economics* / Q000639:trends; D005380:Financing, Government / Q000639:trends; D033161:Government Regulation; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000639:trends*; D008329:Managed Care Programs; D020402:Medical Savings Accounts; D006278:Medicare; D014481:United States