The Four-Party Health Care System – Part 1

An article in the Summer 2009 issue of The Independent Review examined our nation’s four-party health care system. Charles Kroncke and Ronald F. White are the authors of “The Modern Health Care Maze: Development and Effects of the Four-Party System”.

The article states, “Our national health care system is so dauntingly complex that reform efforts seem hopelessly adrift.” The authors feel that reform efforts should begin with looking at health care stakeholders. The obvious ones are: first-party patients, second-party health care providers, third-party payers (private insurance companies and public governmental programs), and fourth-party employers providing health care insurance for their employees (who will become first-party patients).

Other stakeholders involved in our nation’s health care system include: scientists and researchers, research labs, colleges and universities, lawyers, law firms, unions, and professional societies. And we cannot forget all of us who “invest in mutual funds that hold stock in the health care sector.”

The authors point out that the fact that the “health care industry accounts for at least 14% of the gross domestic product (GDP),” illustrates just how complex our health care system is. It goes way beyond the doctor-patient relationship.

“In the United States, politics—that is, each stakeholder group’s capacity to influence powerful legislators—drives health care reform.” Health care has so many stakeholders that true and lasting reform seems out of reach.

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