Etheredge L
George Washington University, USA.
Health Aff (Millwood). 1999 Jul-Aug;18(4):7-19. doi: 10.1377/hlthaff.18.4.7.
Medicare policymakers are considering using private-sector firms to offer and manage a prescription drug benefit. In such arrangements Medicare and its potential contractors will need to consider four major areas of risk: selection risk, cost management risk, risks of government as a business partner, and risks that new Medicare benefits will change competitive advantages. This paper considers these risk factors and suggests a model for Medicare prescription drug coverage. By adapting private-sector purchasing practices and using competitive markets, Medicare could offer prescription drug benefits--at affordable premiums for beneficiaries--without resorting to national price controls for pharmaceutical products.
医疗保险政策制定者正在考虑利用私营公司来提供和管理处方药福利。在这种安排下，医疗保险及其潜在承包商需要考虑四个主要风险领域：选择风险、成本管理风险、政府作为商业伙伴的风险，以及新的医疗保险福利将改变竞争优势的风险。本文考虑了这些风险因素，并提出了一个医疗保险处方药覆盖范围的模型。通过采用私营部门的采购做法并利用竞争市场，医疗保险可以在不诉诸对药品实行全国价格管制的情况下，为受益人提供负担得起的保费的处方药福利。
