Enthoven A C, Singer S J
Stanford Graduate School of Business, USA.
Health Aff (Millwood). 1996 Spring;15(1):39-57. doi: 10.1377/hlthaff.15.1.39.
There is evidence in California of a broad decline in health care costs to employment groups adopting managed care and managed competition--premium reductions up to 10 percent. National comparisons and utilization data generally confirm the beginning of lower costs. Large California medical groups and health systems have responded to pressure by finding ways to reduce costs and improve quality. While examples are encouraging, there is room for improvement. Two levels of competition have emerged and continue to evolve: carrier competition and delivery system competition. Each model has strengths and limitations, but the existing mix is driving down costs.
在加利福尼亚，有证据表明采用管理式医疗和管理式竞争的就业群体的医疗保健成本普遍下降——保费降幅高达10%。全国性比较和使用数据总体上证实了成本降低的开端。加利福尼亚的大型医疗集团和医疗系统通过寻找降低成本和提高质量的方法来应对压力。虽然这些例子令人鼓舞，但仍有改进空间。已经出现并持续演变出两种竞争层面：保险公司竞争和医疗服务提供系统竞争。每种模式都有优点和局限性，但现有的组合正在压低成本。
