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还是价格问题:美国医疗保健支出为何如此之高——纪念乌韦·赖因哈特。

It's Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt.

机构信息

Gerard F. Anderson (

Peter Hussey is vice president and director, Health Care, at the RAND Corporation in Boston, Massachusetts.

出版信息

Health Aff (Millwood). 2019 Jan;38(1):87-95. doi: 10.1377/hlthaff.2018.05144.

Abstract

A 2003 article titled "It's the Prices, Stupid," and coauthored by the three of us and the recently deceased Uwe Reinhardt found that the sizable differences in health spending between the US and other countries were explained mainly by health care prices. As a tribute to him, we used Organization for Economic Cooperation and Development (OECD) Health Statistics to update these analyses and review critiques of the original article. The conclusion that prices are the primary reason why the US spends more on health care than any other country remains valid, despite health policy reforms and health systems restructuring that have occurred in the US and other industrialized countries since the 2003 article's publication. On key measures of health care resources per capita (hospital beds, physicians, and nurses), the US still provides significantly fewer resources compared to the OECD median country. Since the US is not consuming greater resources than other countries, the most logical factor is the higher prices paid in the US. Because the differential between what the public and private sectors pay for medical services has grown significantly in the past fifteen years, US policy makers should focus on prices in the private sector.

摘要

一篇 2003 年题为“关键在于价格,笨蛋”的文章,由我们三人与最近去世的乌韦·莱因哈特共同撰写,文中发现美国与其他国家之间巨大的医疗支出差异主要归因于医疗保健价格。为向他致敬,我们使用经济合作与发展组织(OECD)的卫生统计数据更新了这些分析,并回顾了对原始文章的批评。尽管自 2003 年该文章发表以来,美国和其他工业化国家已经进行了医疗政策改革和医疗体系重组,但价格是美国医疗保健支出高于其他任何国家的主要原因这一结论仍然有效。在人均医疗资源的关键指标(病床、医生和护士)方面,美国与经合组织中位数国家相比,提供的资源仍然明显较少。由于美国的医疗资源消耗并不比其他国家多,最合理的因素是美国支付的价格更高。由于过去十五年中公共和私营部门支付的医疗服务差价显著增长,美国政策制定者应将重点放在私营部门的价格上。

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