The Cost-Shift Payment ‘Hydraulic’: Foundation, History, And Implications
Allen Dobson, Joan DaVanzo and Namrata Sen
Abstract
The cost-shift payment "hydraulic" is an integral component of the fragmented U.S. health care financing system. If private payers’ acceptance of the cost-shifting burden were to erode, our system of health care financing could become unstable. This is especially true for the hospital industry. In this paper we provide a series of examples of cost shifting and a historical profile of the cost shift in the hospital industry since 1980, noting that cost-shifting pressures seem to fluctuate over time and across health care markets. Cost shifting need not be dollar per dollar, as hospitals can absorb some degree of cost-shifting pressure through increased efficiency and decreases in service provision.
http://content.healthaffairs.org/content/25/1/22.fullWe know that the middle class carry the mother-load burden of taxes (federal, state and local) in this country, but honestly until you read this article you really have no idea what the incredible burden is we carry for health insurance for the poor, and uninsured. There is a reason why private health insurance premiums have sky-rocketed over the past twenty years to unsustainable levels (and no misfits at the DU, it has nothing to do with greed and evil capitalism). Not only are we paying for the cost associated with Medicaid/Medicare, when Congress decides to decrease the % of Medicare reimbursement to hospitals, a cost-shift occurs where private health insurance makes up the difference (and in some states like MA, the state bailouts the uninsured costs at a higher level).
We are getting totally screwed at both ends. Worth the read.
