Reinhardt, "Reorganizing the financial flows in American health care," Health Affairs, 1993l12 Suppl:172-93

Two Facets of Health Care Financing

extraction of funds from private households--employer, taxes, private

disbursement of funds from the insurer to the provider--direct from government, employer, individual, or through a managed care corporation

Financing the Collective Insurance Fund

we have a financial labyrinth which effectively hides the true costs of the system from us

Direct Financing by Households

tax credits to make it evener and easier--not everyone knows how to do the taxes--some people will not do it anyways counting on charity

Private employers as pumping stations

professional and economies of scale

only in america are the employeers directly invoved in the markets for health insurance and care

Disproportionate Tax Benefit

The free-lunch Myth

entitlement mentality for "free" employee paid for health care

Social Security Deception

Employeers paying for retierment benefits never had to commit to health care until recently

Government as a pumping station

taxation systems give the same "free lunch" belief

capitation would make a global centralized system much easier to run

slef-selection tends to destabilize over time

Disbursing Funds to Providers

Fee-for-Service Compensation

have to get hospitals and physicians to announce their billing schedule so you can compare them to other hospitals

Prepaid Capitaion

need a way to evaluate it

will be very strong complaining by the first few to get through

Conclusion: On the Vertiue of HIPCs


Table of Contents

Copyright 2000 by David Black-Schaffer