Fuchs (1996) * Broad based tax earmarked for healthcare to provide every American with a voucher for participation in a basic plan. Or a system of mandates with explicit subsidies based on income * Provision of care through integrated health systems, led by physicians, reimbursed by capitation plus modest co-payment from patients at time of use, offering a wide variety of POS options to be paid by patients with after tax dollars * Physicians though an integrated health system will have the incentive, information and infrastructure needed to make these decisions in a cost-effective way. * Physicians should have a prominent place in the governance of these systems. Market completion and government regulation are not the only instruments available to control health care. * Patient copayments will reduce patient moral hazard * POS options include private rooms, a wider choice of physicians. Would accommodate the demands of patients with higher incomes. An American approach to balancing equality and freedom. Not a separate system. * A large private center for technology assessment financed by a small industry wide levy on all health care spending * Need to place financial restraints on technology, the most important factor accounting for the increase in health care’s share of the GDP. * 2 functions * Help to develop and disseminate knowledge about cost effectiveness of technology through research and publications/conferences * Provide legitimacy for cost effective medicine
Cutler (2012) * Short run savings come from reduced payments to providers [reduces payment to Medicare Advantage plans, reduces the update factor for hospitals and increase rebates that drug companies must pay to Medicaid plans when their enrollees use certain prescription medications * Long term savings *