User:Jesanj/All payer
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All payer
Background
Background
In the United States, Medicare pricing is transparent and based on a formula.[1] Health care prices for customers with private insurance, however, are determined by negotiations between the provider and the insurance (the payer).[2] These prices are not transparent, and they are treated as trade secrets.[1] The prices appear to be largely a function of the relative market power of each party and the negotiation itself.[1]
Uninsured patients can also be negotiate prices with providers.[3] The exact same service at the same facility can differ depending upon the payer (price discrimination).[1] For example,
Between any grouping of provider and payer, there is a distribution of market power. leverage to effect price raises, while if
Goals
A goal of all payer is to increase the market power of payers.[4]
Reduce administrative costs
The White House's Fiscal Commission, led by Erskine Bowles and Alan Simpson, listed the idea of raising the eligibility age with the likes of such dramatic structural changes as the public option, block grants or an all-payer system
Presence
All payer characteristics are found in the health systems in France, Germany, Japan, and the Netherlands.[4]