Weil T
Bedford Health Associates, Inc., Asheville, NC 28804, USA.
Hosp Health Serv Adm. 1996 Summer;41(2):266-80.
Health networks and HMOs--as strategies to reform the American health system--are considered by many elected officials and providers to be the most effective way to improve the delivery of medical care at a reduced cost. Strongly swaying these proposals are the fiscal pressures that now require us to harness such entitlements as Medicare and Medicaid. As these health networks and capitated payment approaches are being aggressively forged by hospitals, physicians, and insurers, the probable consequences are that one alliance will eventually dominate most geographic regions (except for our nation's largest metropolitan areas) and these oligopolies will tend to behave as a monopoly. More simply stated, this article argues that many healthcare markets will either evolve into monopolies or, at best, oligopolies.
健康网络和健康维护组织——作为美国医疗体系改革的策略——被许多民选官员和医疗服务提供者视为以降低成本改善医疗服务提供的最有效方式。现在要求我们利用诸如医疗保险和医疗补助等福利的财政压力，对这些提议产生了强烈影响。随着医院、医生和保险公司积极打造这些健康网络和按人头付费方式，可能的后果是一个联盟最终将主导大多数地理区域（除了我国最大的大都市区），并且这些寡头垄断企业往往会表现得像垄断企业。简而言之，本文认为许多医疗保健市场要么会演变成垄断，要么充其量成为寡头垄断。
