The United States has more competition than any other country. Why has competition not driven value improvement?
The United States health care system has the wrong kind of competition, at the wrong level, and on the wrong things. Competition is value dividing, or “zero-sum.” Gains of one system participant come at the expense of others, through cost shifting, efforts to increase bargaining power, and restriction of services. Zero-sum competition actually reduces value through added administrative costs and restricting high value services; while creating inappropriate cross subsidies such as higher prices for small groups and for the uninsured. Instead of competition to divide value, the United States needs to move to competition that drives sustained increases in value.
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