Insurance, competition and cost containment. 1982

W Greenberg

Most economists have suggested that the growing presence of insurance, including Medicare, Medicaid, Blue Cross and the commercial insurers, is largely responsible for the rapid rise of health care costs in the United States. It is the contention of this paper, however, that the insurance industry in the private sector in the United States may help in the effort to contain costs rather than solely stimulating rapidly increasing costs. A number of methods that insurers have employed to contain costs, including monitoring provider behavior and prospective reimbursement, are identified. It is cautioned, however, that although health insurer cost containment efforts will continue to expand in the future, perversities in the U.S. tax laws, potential provider opposition and the complexities of medicine will continue to make cost containment a difficult task.

UI MeSH Term Description Entries
D007341 Insurance Coverage by contract whereby one part indemnifies or guarantees another against loss by a specified contingency. Indemnity,Insurance Premiums,Insurance Premium,Premium, Insurance,Premiums, Insurance
D007343 Insurance Carriers Organizations which assume the financial responsibility for the risks of policyholders. Insurance Providers,Insurers,Carrier, Insurance,Carriers, Insurance,Insurance Carrier,Insurance Provider,Insurer,Provider, Insurance,Providers, Insurance
D007347 Insurance, Dental Insurance providing coverage for dental care. Prepaid Dental Care,Care, Prepaid Dental,Dental Care Plan,Dental Insurance,Plan, Dental Care,Plans, Dental Care,Dental Care Plans,Dental Care, Prepaid
D007348 Insurance, Health Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading. Group Health Insurance,Health Insurance,Health Insurance, Voluntary,Health Insurance, Group,Health Insurances,Insurance, Group Health,Insurance, Voluntary Health,Insurances, Health,Voluntary Health Insurance
D011445 Prospective Payment System A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims. Discretionary Adjustment Factor,Prospective Pricing,Prospective Reimbursement,Reimbursement, Prospective,Adjustment, Discretionary,Adjustment Factor, Discretionary,Adjustment Factors, Discretionary,Adjustments, Discretionary,Discretionary Adjustment,Discretionary Adjustment Factors,Discretionary Adjustments,Factor, Discretionary Adjustment,Factors, Discretionary Adjustment,Payment System, Prospective,Payment Systems, Prospective,Pricing, Prospective,Prospective Payment Systems,Prospective Reimbursements,Reimbursements, Prospective,System, Prospective Payment,Systems, Prospective Payment
D003363 Cost Control The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed) Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D004465 Economic Competition The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms. Competition, Economic,Competitions, Economic,Economic Competitions
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.

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