HEALTHCARE IN THE 21ST CENTURY: THE ROLE OF COMPETITION
Healthcare is the single largest sector of the economy, it is undergoing extensive and controversial reform, and the central goals of reform–universal coverage and cost control–have not yet been achieved. Since the Affordable Care Act relies heavily on private markets to provide health services and health insurance, competition will play a crucial role in reform. Yet, competition policy issues are especially challenging in healthcare, where markets are distorted by the fee-for-service payment system, insurance coverage, and market power. Competition can help correct these distortions, enhancing access and affordability, but it can also threaten the supply of doctors, new drugs, and higher levels of care. The challenge is to develop policies that achieve the right balance of these goals.
The symposium addresses the key current competition issues in healthcare, including: whether the government should be tougher or more lenient on hospital mergers, given their potential for both higher prices and improved care; whether Accountable Care Organizations, a major initiative of the Affordable Care Act, need to be more closely monitored by the federal antitrust agencies or instead subject to direct regulation; whether the efficiencies of hospital-physician integration can be realized without converting doctors into hospital employees; whether lower courts are correctly evaluating reverse payment patent settlements in the wake of the Supreme Court’s Actavis decision; whether the FDA should limit off-label uses of prescription drugs; whether the nation should make greater use of buyer power as a cost control device, allowing the federal government, for example, to negotiate prescription drug prices or letting insurance companies consolidate to obtain bigger discounts from hospitals and doctors; whether a more flexible regulatory environment is likely to produce a more diverse and cost-effective healthcare workforce; and whether market innovations are likely to improve the delivery of assisted reproductive services.