How Price Regulation Is Needed To Advance Market Competition

• Published in: Health affairs (Millwood, Va.) Vol. 41; no. 1; pp. 26 - 2
• Main Authors: Berenson, Robert A, Murray, Robert B
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.01.2022
• Subjects: Acquisitions & mergers; Antitrust; Budgets; Competition; Complexity; Developed countries; Efficiency; Health care expenditures; Health care industry; Health care policy; Health insurance; Health policy; Hospitals; Incentives; Industrialized nations; Market entry; Markets; Medicare; Patient control; Patients; Policy making; Price regulations; Prices; Quality of care; Regulation; Wisdom; United States > US
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2021.01235

In US health policy, conventional wisdom holds that market competition and price regulation are mutually exclusive strategies to stem high and rising provider prices. This incorrect assumption centers on the belief that robust competition in US commercial health insurance markets must include provider price competition. Other developed countries, however, commonly implement price regulation to support competition over important care delivery components other than prices, including quality of care and patient choice, and to provide stronger incentives for providers to improve operating efficiency. Conventional US policy wisdom also holds that price regulation inevitably will fail because of excessive complexity or succumb to the interests of regulated entities. This analysis challenges conventional wisdom by urging policy makers to consider regulations that limit out-of-network provider prices and establish flexible hospital budgets. Each of these proposals would require less administrative complexity and burden than other proposed approaches. We conclude that it is time to move discussions from whether to regulate hospital prices to determining how best to do so.