Health care cost and access problems intensify: initial findings from HSC's recent site visits.

Cara S Lesser, Paul B Ginsburg
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Abstract

Continued high-cost trends are threatening the affordability of health insurance and many consumers' access to care. Early findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities show the retreat from tightly managed care continues to shape local health care markets. Employers are aggressively shifting higher health costs to workers, and absent tight managed care controls to limit the use of care and slow payment rate increases, hospitals and physicians in many markets are competing fiercely for profitable specialty services. These developments have sparked growing skepticism about the potential for market-led solutions to the cost, quality and access problems facing the health care system today.

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卫生保健费用和获取问题加剧:HSC最近实地考察的初步发现。
持续的高成本趋势正威胁着医疗保险的负担能力和许多消费者获得医疗服务的机会。卫生系统改革研究中心(HSC) 2002-03年对12个具有全国代表性的社区进行的实地考察的早期发现表明,从严格管理的医疗保健的撤退继续影响着当地的医疗保健市场。雇主正积极地将更高的医疗成本转嫁给员工,由于缺乏严格的医疗管理控制来限制医疗服务的使用和缓慢的支付率增长,许多市场上的医院和医生正在激烈竞争有利可图的专业服务。这些事态发展使人们越来越怀疑,以市场为主导的解决方案能否解决当今卫生保健系统所面临的成本、质量和可及性问题。
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Small employers and self-insured health benefits: too small to succeed? Employer-sponsored health insurance: down but not out. Rising hospital employment of physicians: better quality, higher costs? Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform. Physicians slow to e-mail routinely with patients.
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