Health Care Spending Control:

The Experience of France, Germany, and Japan

T-HRD-92-12: Published: Nov 19, 1991. Publicly Released: Nov 19, 1991.

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GAO discussed the health care systems in France, Germany, and Japan. GAO noted that: (1) France, Germany, and Japan provide universal access to health insurance while spending less on health care than the United States; (2) under the U.S. and the three countries' health care systems, multiple payers provide health insurance, people typically get health insurance for themselves and their dependents at their place of employment, people can choose their own physician on a fee-for-service basis, and both private and public hospitals deliver inpatient care; (3) health care system regulations in France, Germany, and Japan guarantee access to health insurance to all residents, standardize insurers' payments to physicians and hospitals, and control increases in health care spending; (4) the three countries use many insurers to achieve universal health care coverage, standardize rates for reimbursing providers without the government setting rates unilaterally, and moderate increases in health spending by putting entire health care sectors on a budget; and (5) budget controls neither relieve all spending pressures nor ensure quality or efficiency.

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