Scandlen Greg
Manag Care Q. 2002 Spring;10(2):13-7.
The essential problem in healthcare has never been fee-for-service. The problem is third-party payment that inevitably leads to excessive demand for services. Third-party payers will always try to limit the use and cost of services to reduce their exposure. The big question facing us in the next 10 years is who decides what gets paid for and what doesn't. Will it be employers, insurers, the government? Or it will it be consumers? Many employers have concluded that Americans are perfectly capable of expressing their preferences and choices in healthcare. But they need to understand that resources are limited and trade-offs are required.
医疗保健的核心问题从来都不是按服务收费。问题在于第三方支付,这不可避免地导致对服务的过度需求。第三方支付方总会试图限制服务的使用和成本,以降低自身风险。未来十年我们面临的重大问题是谁来决定什么能得到偿付,什么不能。会是雇主、保险公司、政府吗?还是消费者?许多雇主得出结论,美国人完全有能力在医疗保健方面表达自己的偏好和选择。但他们需要明白资源是有限的,需要进行权衡取舍。