Early concerns of hospital cost shifting

From page 388 of Paul Starr’s The Social Transformation of American Medicine:

[In the early 1970s], the commercial insurance companies worried that if the government tried to solve its fiscal problems simply by tightening up cost-based reimbursement, the hospitals might simply shift the costs to patients who pay charges, which would force up commercial insurers’ rates and make them less competitive with Blue Cross. Hence the commercial insurance industry began to favor more comprehensive responses, such as community health planning or state regulation of hospital charges.

In the endnote for this passage, Starr cites

Orsini L. 1974. Hospital Financing: Public Accountability–The Case of Rates Prospectively Determined by State Agencies for All Patients. Viewpoint. Health Insurance Association of America. January.

I am unable to find a copy of this paper. As a student of cost shifting, I would love to read it.

This is my last planned post on Starr’s book (all posts about it found under the STAM tag). It was published in 1982, nearly 30 years ago. Though many of the issues described are relevant today, it would seem an update would be worthwhile. I’d certainly read it.

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