Health Care Cost Containment Strategies Used In Four Other High-Income Countries Hold Lessons For The United States
- Mark Stabile1,*,
- Sarah Thomson2,
- Sara Allin3,
- Seán Boyle4,
- Reinhard Busse5,
- Karine Chevreul6,
- Greg Marchildon7 and
- Elias Mossialos8
- 1Mark Stabile (mark.stabile{at}utoronto.ca) is a professor of economics and public policy in the Rotman School of Management and School of Public Policy and Governance, University of Toronto, in Ontario.
- 2Sarah Thomson is a senior lecturer in health policy in the Department of Social Policy at the London School of Economics and Political Science (LSE), in the United Kingdom.
- 3Sara Allin is an assistant professor in the School of Public Policy and Governance at the University of Toronto, in Ontario, Canada.
- 4Seán Boyle is a senior research fellow in health and social care at LSE.
- 5Reinhard Busse is a professor and the department head for health care management in the Faculty of Economics and Management, Berlin University of Technology, in Germany.
- 6Karine Chevreul is deputy head of the Paris Health Economics and Health Services Research Units, in France.
- 7Greg Marchildon is the Canada Research Chair in Public Policy and Economic History at the Johnson-Shoyama Graduate School of Public Policy, University of Regina, in Saskatchewan, Canada.
- 8Elias Mossialos is the Brian Abel-Smith Professor of Health Policy in the Department of Social Policy at LSE.
- ↵*Corresponding author
Abstract
Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000–10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls—measures unlikely to be adopted in the United States—if they are also to meet cost containment goals.
