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Mon Apr 16, 2018, 10:46 PM

Would Americans Accept Putting Health Care on a Budget?

The intuitive appeal of such a system is growing, and itís getting a test in Maryland.

'If you wanted to get control of your household spending, youíd set a budget and spend no more than it allowed. You might wonder why we donít just do the same for spending on American health care.

Though government budgets are different from household budgets, the idea of putting a firm limit on health care spending is far from unknown. Many countries, including Canada, Switzerland and Britain, pay hospitals entirely or partly this way.

Under such a capped system, called global budgeting, a hospital has an incentive to deliver less care ó including reducing hospital admissions ó and to increase the efficiency of the care it does deliver.

Capping hospital spending raises concerns about harming quality and access. On these grounds, hospital executives and patient advocates might strongly resist spending constraints in the United States.

And yet some American hospitals and health systems already operate this way, including Kaiser Permanente and the Veterans Health Administration. To address concerns about access and quality, these programs are usually paired with quality monitoring and improvement initiatives.

That brings us to Marylandís experience with a capped system. The evidence from the state is far from conclusive, but this is a weighty and much-watched experiment for health researchers, so itís worth diving into the details of the latest studies.

Starting in 2010 with eight rural hospitals, and expanding its plan in 2014 to the stateís other hospitals, Maryland set global budgets for hospital inpatient and outpatient services, as well as emergency department care. Each hospitalís budget is based on its past revenue and encompasses all payers for care, including Medicare, Medicaid and commercial market insurance. Budgets for hospitals are updated every year to ensure that their spending grows more slowly than the stateís economy.'>>>


Sound familiar?

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Reply Would Americans Accept Putting Health Care on a Budget? (Original post)
elleng Apr 2018 OP
PoindexterOglethorpe Apr 2018 #1

Response to elleng (Original post)

Tue Apr 17, 2018, 12:55 AM

1. You mean it's not already on a budget?

Do we actually have unlimited health care and I somehow missed that?

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