Ellis M S
LSU School of Medicine.
J La State Med Soc. 1994 Jul;146(7):298-311.
Current health system reform efforts are based on the notion that the government can best design a cost efficient system. The government already operates several health care systems, including Medicare and Medicaid. Despite the development of a plethora of cost-control initiatives, such as price-fixing, utilization and peer review, and Diagnostic Related Groups, the government has been unable to control the burgeoning costs of these programs. Health system reform efforts appear directed toward the expansion of many of these same failed efforts. Only by first evaluating where the money goes can real efforts at improving the economics of the system--without jeopardizing quality of care--be successful. The author has examined the Louisiana Medicaid program in a previous article. This article examines the function and expenditures of the Louisiana Medicare program: Part B, the "physician's component" and Part A, the "hospital component."
当前的医疗体系改革努力基于这样一种观念，即政府能够最有效地设计出一个成本效益高的体系。政府已经运营着多个医疗保健系统，包括医疗保险和医疗补助计划。尽管已经开展了大量成本控制举措，如定价、使用情况和同行评审以及诊断相关分组，但政府仍无法控制这些项目不断飙升的成本。医疗体系改革努力似乎旨在扩大许多同样失败的举措。只有先评估资金流向何处，才能在不危及医疗质量的情况下，真正成功地努力改善该体系的经济效益。作者在前一篇文章中研究了路易斯安那州的医疗补助计划。本文将研究路易斯安那州医疗保险计划的功能和支出：B部分，即“医生部分”，以及A部分，即“医院部分”。
