Universal health care in America? Researchers say fix skyrocketing medical prices first

PISCATAWAY, N.J. — With or without the coronavirus pandemic, it's becoming more and more expensive to keep yourself healthy in the United States. Compared to other high-income nations, a study finds Americans pay the highest health care prices in the world. Researchers at Rutgers University say it's not too late to slow this inflation, but policymakers need to cut the price of medical treatments, not how many are done.

Study authors find standardizing fee-for-service payments doctors receive and creating a structure for negotiations between insurers and health care providers can help cut the costs facing sick Americans. Researchers add doctors in most countries using universal health insurance receive fee-for-service payments. While the U.S. has generally disregarded this policy, countries like France, Germany, and Japan have seen their health care costs drop below America's using this payment option.

In contrast, U.S. policymakers have instead looked at ending all fee-for-service payments to physicians. This provides doctors with an incentive to perform more procedures instead of negotiating the price of treatments and addressing the main cost of health care bills.

Health care policies working overseas

Researchers interviewed 37 stakeholders and health policy experts in France, Germany, and Japan to understand how those nations keep patient costs down. The study finds each country focuses on standard pricing for outpatient health care services.

“The parties involved, the frequency of fee schedule updates and the scope of the negotiations vary, but all three countries attempt to balance the interests of payers with those of physician associations,” explains lead author Michael K. Gusmano from the Rutgers School of Public Health in a university release.

Their results conclude that policymakers must first address the pricing system of medical care before creating a universal health care system that is truly affordable. Researchers add that the idea of universal health coverage continues to gain support, especially as the number of COVID-19 cases reaches 12 million in America alone.

Gusmano finds the opposition to fee-for-service medicine in the U.S. flawed, as other countries continue to show the system works at keeping prices lower. The study reports France, Germany, and Japan all limit the income a doctor can make. This is done through adjusting standard treatment fees periodically and using other policies to limit the number of services physicians provide.

As American lawmakers consider Medicare-for-All and expansions to the Affordable Care Act, Gusmano's study finds these systems will have trouble living up to their promises if health care systems don't get more regulation.

The study appears in the journal Health Affairs.