• All cost shifting, all the time

    Cost shifting seems to be of interest to people, and there is a lot more I can write about it. So, expect more next week. Put on your thinking caps. I’m going to go through the theory. No math, just figures and a bit of jargon. Try to stick with me and ask questions.

    If you want to get a head start, scroll through Michael Morrisey’s book on the subject. Look for the discussion of the figures that appear on pages 14 (Fig. 2-1), 17 (Fig. 2-2), and 41 (Fig. 4-2).

    If you get through that, see also Cutler’s paper (sorry, no ungated version that I know of). He’s got a nice graphical theory section.

    I’ll be describing both of these in detail, so you can also just wait. I’ll also give my short summary of the best empirical work on the subject. I’ll do this all in four posts. Then I will probably shut up about it for a while, unless someone provokes me. 🙂

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    • I’m sure that it is an interesting research project to try to determine when, if and how much cost shifting occurs and I don’t want to derail what I’m sure will be an interesting discussion but …

      What if there was one standard price for medical services regardless of payer?
      What benefits would accrue to consumers if they could know the price for a service?
      What benefits would accrue to payers if they didn’t have to undertake complex negotiations with all of their providers?
      What benefits would accrue to providers if they didn’t have to undertake complex negotiations with payers and could rely on being paid 100% of a standard price for their services?
      What would be the downside of this for payers, consumers and providers?