Health Care Policy and Regulation

1. Front Matter

   Pages i-x

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2. Introduction

   1. Health Care Policy and Regulation: Introduction

      • Thomas A. Abbott III

      Pages 1-9

3. Health Care Reform

   1. Front Matter

      Pages 11-11

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   2. Lessons from Public Utility Regulation for the Economic Regulation of Health Care Markets: An Overview

      • Thomas A. Abbott III, Michael A. Crew

      Pages 13-43

   3. Regulatory Strategies Under Managed Competition Health Care Reforms

      • Mark Schlesinger

      Pages 45-79

   4. Health Care Cost Containment in Connecticut

      • L. Spencer Cain

      Pages 81-91

   5. Health Care Reform in New Jersey

      • Pamela S. Dickson

      Pages 93-95

   6. Health Security Act: Summary and Impact

      • Ronald Rouse, Philip Vernon, Linda Stackman, Keith Servis

      Pages 97-101

4. Price Regulation

   1. Front Matter

      Pages 103-103

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   2. Regulating Pharmaceutical Prices

      • Thomas A. Abbott III

      Pages 105-141

   3. Hospital Price Regulation: Evidence and Implications for Health Care Reform

      • Jack Hadley

      Pages 143-162

   4. Paying Physicians as Agents: Fee-For-Service, Caption, or Hybrids?

      • Mark V. Pauly

      Pages 163-180

5. Quality Regulation

   1. Front Matter

      Pages 181-181

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   2. Medical Practice Guidelines and the Efficient Allocation of Resources

      • John A. Rizzo, Jody L. Sindelar

      Pages 183-203

   3. Contending Views of Quality Management in Health Care: Implications for Competition and Regulation

      • David Blumenthal, Richard Bohmer

      Pages 205-229

   4. Measuring and Improving Quality in Health Care

      • Mark R. Chassin

      Pages 231-242

6. Back Matter

   Pages 243-261

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5 care reforms. Part II: Price Regulation The second partofthis volume examines the role ofprice regulation in controlling health care costs. It contains three chapters. In chapter seven, I examine the alternatives for regulating pharmaceutical prices. In chapter eight, Jack Hadley examines the impactofvarious forms ofhospital price regulation; while in chapter nine,MarkPaulyexaminestheroleofpriceregulation incontrollingphysician fees. Chapter seven focuses on the issue of regulating pharmaceutical prices. There are two key issues examined in this paper. First, is there a clear need for price regulation, and second, can price regulation work in this industry? In response to the first question, I come to the conclusion that the proponents ofprice regulation have not really proven their case. Although the financial returns in the pharmaceu­ tical industry have been slightly higher than expected during the 1970s and 1980s, there is not overwhelming evidence of"price gouging" or excessive profits on the part of the industry. In response to the second question, the answer is clearly no. The traditional approaches to price regulation will not have the intended affect of eliminating excess profits from the industry while maintaining the incentives for research and development. First, rate-of-return regulation, the most natural approach, would result in many adverse incentives-includingexcessive investment in research and developmentinorderto inflatetheratebaseused tocalculatedtheallowablereturns.

• competition
• health
• health care
• hospital
• regulation

• Graduate School of Management, Rutgers University, Newark, USA

  Thomas A. Abbott

Policies and ethics