title: Health care cost containment strategies used in four other high-income countries hold lessons for the United States.
abstract: Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000-10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls--measures unlikely to be adopted in the United States--if they are also to meet cost containment goals.
authors.affiliation: Rotman School of Management, University of Toronto, Ontario. mark.stabile@utoronto.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Stabile
authors.forename: Sarah
authors.initials: S
authors.lastname: Thomson
authors.forename: Sara
authors.initials: S
authors.lastname: Allin
authors.forename: Seán
authors.initials: S
authors.lastname: Boyle
authors.forename: Reinhard
authors.initials: R
authors.lastname: Busse
authors.forename: Karine
authors.initials: K
authors.lastname: Chevreul
authors.forename: Greg
authors.initials: G
authors.lastname: Marchildon
authors.forename: Elias
authors.initials: E
authors.lastname: Mossialos
mesh_terms: D002017:Budgets / Q000458:organization & administration; D002170:Canada; D003363:Cost Control / Q000191:economics / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration; D016527:Drug Costs / Q000706:statistics & numerical data; D005602:France; D005858:Germany; D017048:Health Care Costs; D006291:Health Policy; D006801:Humans; D012051:Reimbursement Mechanisms / Q000191:economics / Q000458:organization & administration; D013673:Technology Assessment, Biomedical; D006113:United Kingdom; D014481:United States; D019472:Universal Health Insurance / Q000191:economics / Q000458:organization & administration