The Managed Care Industry
Balancing Market Forces and Regulation
In a market-oriented health care system, regulation is necessarily a balancing act. Its proper role is to promote appropriate accountability and consistency of care without needlessly restricting the freedom to innovate. Whether this balance can be achieved and maintained depends on a number of variables, of which the most important may be the public's perception of the regulatory challenge.
There is a compelling need to look beyond the day's headlines. Reaching the goal of balanced regulatory policymaking requires context. Decisions need to be based on a clear, objective understanding of whether market-based health care reform is, on the whole, working—that is, delivering generally superior care to more Americans at more affordable cost—and if so, whether a relatively heavy regulatory hand is necessary or appropriate to ensure that reform stays on track.
Context also means recognizing what is at stake when new regulations and restrictions are proposed. For example, increasing the
Rick Smith, vice president, Public Policy and Research, AAHP, and Phil Blando, deputy director, Strategic Planning, AAHP, also contributed to this chapter.