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| May 1998 Issue Brief No. 13 |
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Competition, Quality of Care and the Role of the Consumer
1998
The Milbank Quarterly, vol.76, no.4 (1998): 737-743
Catherine G. McLaughlin, Paul B. Ginsburg
ittle evidence exists of a relationship between competition and
quality of medical care. In fact, they may not even be corsrelated with one another.
Emergence of HMOs in the health care marketplace has altered provider behavior and has led
to a dramatically different health insurance market, but they are neither a necessary nor
sufficient condition for market competition among providers. A factor more directly linked
to competition is the degree of sensitivity to price, which begins in the insurance market
and also reflects the role of employers. When insurance markets are highly competitive,
health plans are more sensitive to price differences among providers, an effect that can
take place without a significant HMO presence in the market. Other factors include the way
people interpret the meaning of competition; competing on the basis of price with no
controls on quality; the way that health insurance carriers have introduced competition
into the marketplace; the role of consumers; and the type and extent of consumer
information about health care quality.
For a full copy please visit The Milbank Quarterly. (Subscription required.)
