Financial Efficiency

Another critical measure of a health care system is whether it operates in a finan- cially efficient manner. Currently, the multitude of private and public insurers in the United States substantially drives up the administrative costs of the health care system. At the same time, the atomized and essentially entre- preneurial nature of our health care system makes it virtually impossible to impose effective cost controls. For example, doctors have responded to financial limits on Medicare payments by raising the fees they charge to non-Medicare patients, a pro- cess known as cost shifting. Neither of these problems was addressed by the ACA.