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![handle is hein.amenin/aeiaech0001 and id is 1 raw text is: The Political Econorny of Health
Reforrn: Price Regulation vs.
Regulated Cornpetition
>3 ~ C'
LV 0103 t. macrota
September 2021
ThecUS has mature -E-thL-udor [ itst -itios and cni;s:aing insurance in cat arran;;e-
m entc that rt the scope ?f poenti, fu ure reftrns. The realistic path r_ fnremfenaLsm Dne
wayil 'Dr an her: toward t eiherr ( ihter gov>E'0rnrnenr reguion pces p] a0c isiid ir rnsurance anc
servces y rce) cr a strucured market ta . leads the sectors suppliers
of medical serces set c om peti' ve pis on her 'n.%How eaich .Oon woul d a'reth
im'-pflrn-n te through the n I' actu*cal pticaand adrniistnirve procsses isa onortant
ccnsiderat.ioi. Medicare and Med caid rcvca tha i paymert r-gulation can pr'duce the dsire
reduLions in spen din;2 buo : so lead to specia3-nerui in Cun a rirg div. A struc Liurcd market.
wIn the right satcguards, can deliver strong results by sec -corretoi arnd bi nug more resilin
to isidirn nution. It wI c-cly be adoptey , i 'Nhweetr, If cionSLmers .elle:vet wiI !eaid to
ncrial en efrits and n risks,
Health p 7 cy-i not imptmrented in an apolitical
vacuum. Market faiurss iW 1he health sector FOrce
potlcal leaders in al1 countries to acthvety super-
vise th their insurance sysctrms and h w care is
delivered to patents The question is the nature of
th3ose':n nevei 'cns, not whether ihey will occur,
and how they .m it be expected to evolve and
cliange over i cm whns takcn up in the context of
a oaticular form of goem'nent anctwithi a nation's
political culture.
P-ut another way. wh1en: weighing the ieris o
alternative policies, one must consider not just
styiizcd simulations but also what will likely nappen
whcn policies are pu- mcd and implemented in the
real won d, with periodieci eections, governance
structuires, a nd systems a nd cultures c-f public admie-
Istration. Among ot h:r ings, government agencieis
tasked with im tpiemienting policies in the health
sector often must do so earth purposeni ilmits on
heir opcrationail capacities (and trudgts) imnper-
fect i nfcrmadtion, and heavy pressure an d oversigi.t
froin elected leaders.
When health oi quertions are viuwed this
way', the task of finding the right lormula becomes
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