Health Affairs

Health Affairs, 28, no. 5 (2009): 1305-1315 doi: 10.1377/hlthaff.28.5.1305 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Overview

Market Failure And The Failure Of Discourse: Facing Up To The Power Of Sellers

Bruce C. Vladeck and Thomas Rice

The United States spends far more than other countries do on its health care system, but comparative data strongly imply that Americans are not receiving their money’s worth. There is much hand-wringing about spending, but little attention is paid to the main culprit: lack of market power by purchasers—something that exists in nearly all other countries. This lack of attention is not surprising, however, given that having an open discussion could ultimately lead to more regulation—and a major redistribution of resources away from providers and back to employers, individuals and families, and taxpayers.

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