Competition in the Marketplace: Health Care in the 1980s


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Health care markets have become increasingly concentrated

These plans encountered strong opposition from the medical establishment, but they also attracted a large number of enrollees. Today, such prepaid health plans are commonly referred to as health maintenance organizations HMOs.

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The legislation was proposed by the Nixon Administration in an attempt to restrain the growth of health care costs and also to preempt efforts by congressional Democrats to enact a universal health care plan. The purpose of the legislation was to stimulate greater competition within health care markets by developing outpatient alternatives to expensive hospital-based treatment. Passage of this legislation also marked an important turning point in the U. In the decade following the passage of P. Stiff opposition from the medical profession led to the imposition of regulatory restrictions on HMO operations.

But the continued, rapid growth in health care outlays forced government officials to look for new solutions. National health expenditures grew as a proportion of the overall gross national product GNP from 5. Over the following decade, the Federal Government authorized payments for more than 2, Medicare procedures performed on an outpatient basis.

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Responding to the relaxed regulatory environment, physicians began to form group practices and open outpatient centers specializing in diagnostic imaging, wellness and fitness, rehabilitation, surgery, birthing, and other services previously provided exclusively in hospital settings.

Health care costs, however, continued to spiral upward, consuming In an attempt to slow the growth rate, Congress in capped hospital reimbursement rates under the Medicare program and directed the secretary of HHS to develop a case mix methodology for reimbursing hospitals based on diagnosis-related groups DRGs. Following months of intense negotiations involving federal officials and representatives of the hospital industry, the Reagan Administration unveiled a Medicare PPS.

Under the new system, health conditions were divided into DRGs, with a fixed hospital payment rate assigned to each group. Once the DRG system was fully phased in, Medicare payments to hospitals stabilized.

Since DRGs were applied exclusively to Medicare payments, hospitals began to shift unreimbursed costs to private health insurance plans. Plan benefits were reduced. Employees were required to pay a larger share of health insurance premiums. More and more employers—especially large corporations—decided to pay employee health costs directly rather than purchase health insurance.

And a steadily increasing number of large and small businesses turned to managed health care plans in an attempt to rein in spiraling health care outlays. Medicaid recipients with physical and developmental disabilities became eligible to participate in the Arizona Long-Term Care System as a result of this program expansion.

During the late s and early s, managed care plans were credited with curtailing the runaway growth in health care costs. They achieved these efficiencies mainly by eliminating unnecessary hospitalizations and forcing participating physicians and other health care providers to offer their services at discounted rates. According to one analysis, nearly state laws governing managed health practices were enacted during the s.

Research studies have yielded little evidence that managed health care excesses have undermined the quality of health care services. Over the past 15 to 20 years, the public outcry against draconian managed care practices has waned, primarily due to the expanded out-of-network options afforded to participants in HMOs, PPOs, and POS health plans. Kane, R. Population growth, a changing epidemiology, a growing medical tourism industry, healthcare infrastructure developments, an expanding health insurance, digital transformation and new technologies will remain key market drivers.

Imported medical devices will not be cleared by Customs unless a pre-approval for importation of the consignment is issued by MoHAP. The local representative must be appointed by written contract stating the appointment of the local authorized representative by the company. The local representative should be licensed by the MoHAP.

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Qualification of Registration of Medical Devices The application to place a medical device on the UAE market must be made by the manufacturer or its authorized representative. The manufacturer or its authorized representative is required to maintain objective evidence on the safety and effectiveness of the medical device. The registration or listing of a medical device shall be valid for five years unless suspended or revoked by the MoHAP's Registration and Drug Control Department, or terminated by the registrant.

Applications for renewal of registration shall be made at least 90 days before the expiry date of registration of the device. The application shall include submission of filled in application form and information pertaining to changes that were made to a registered device.

A Competitive Health Care Marketplace

A law allowing percent foreign ownership of companies in the UAE for certain sectors is now in force. The law is designed to make the country more attractive for investors while limiting the impact on local businesses.

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Foreign companies seeking to establish an entity onshore in the UAE would previously have to team up with a UAE national, who was required to own 51 percent of the shares of the company. There are also free-zones with the UAE which offers a wide variety of benefits to businesses and a degree of flexibility including:. No national agent required for branch offices of foreign companies. Special assistance in getting work permits for staff. Some of the barriers include:.


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A small, young, and fragmented population. The high number of expatriate workers affecting demographics and healthcare. The fragmentation of the healthcare system led by Abu Dhabi and Dubai. A lack of federal health insurance. A shortage of qualified healthcare personnel. Customer Price Sensitivity.

Vertical Integration: 80’s Fad or Health Care’s Future?

Currently, nearly 70 percent of more than 4, facilities, including hospitals, ambulatory services, clinics, polyclinics and primary care centers, have international accreditation. BMI estimated in that medical device market would grow at a compound annual rate of 8.


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Given that the UAE produces relatively little medical equipment domestically, this means significant business opportunities for international companies. Technavio, a market research company that focuses on emerging markets, estimated in that this market would grow at a compound annual growth rate of over 11 percent from to This growth is partly driven by government initiatives around the digitization of electronic medical records. At the same time, it has endeavored to make the country a regional hub for medical research and events. The UAE needs to increase the number of hospitals, despite an expanding private healthcare sector.

There are numerous hospital construction and renovation programs underway, as a result of both public and private investment.

Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s
Competition in the Marketplace: Health Care in the 1980s Competition in the Marketplace: Health Care in the 1980s

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