Health Care Cost Containment Strategies Used In Four Other High-Income Countries Hold Lessons For The United States

Abstract

Around the world, rising health care costs are claiming a larger share of national budgets. This article reviews strategies developed to contain costs in health systems in Canada, England, France, and Germany in 2000-10. We used a comprehensive analysis of health systems and reforms in each country, compiled by the European Observatory on Health Systems and Policies. These countries rely on a number of budget and price-setting mechanisms to contain health care costs. Our review revealed trends in all four countries toward more use of technology assessments and payment based on diagnosis-related groups and the value of products or services. These policies may result in a more efficient use of health care resources, but we argue that they need to be combined with volume and price controls-measures unlikely to be adopted in the United States-if they are also to meet cost containment goals. T he past decade saw a considerable increase in health care spending in many high-income nations. Despite efforts to contain health care costs, the most recent data from the Organization for Economic Cooperation and Development show that average per capita spending on health among member countries increased by more than 70 percent between 2000 and 2010.

The incidence of high medical expenses by health status in seven developed countries

“…A final implication of this study is that attaining financial protection on par with that achieved in France will require more comprehensive income-based limits on OOP spending than currently exist in most countries. However, the magnitude of financial risk revealed here may indicate a more general need to shift from cost-sharing measures as a way to reduce health care costs, and toward alternative policy mechanisms such as are being attempted in many other countries [31]. …”

The Changing Role of Government in Financing Health Care: An International Perspective

“…However, the authors note that part of the reason for the small behavioral response found here may be that the policy was either not applicable or not binding for many users, limiting the potential for savings. There is some evidence of movement towards strategies that promote efficiency through value-based cost sharing (using cost sharing to encourage patients to use medication, services, and providers that offer better value than other options) rather than simply applying user fees across the board (Stabile et al 2013).…”

Healthcare Spending: The Role of Healthcare Institutions from an International Perspective

“…It has been able to accomplish cost containment mainly through a tightly controlled nationally uniform schedule set by the government (Hashimoto, et al, 2011). Other countries such as Canada, the UK, France, and Germany have also used budget and price controls as a method of healthcare cost containment with differing degrees of effectiveness (Stabile, et al, 2013).…”