Cost Shifting In The Current Medical Environment

"Cost shifting" occurs when there is not a fair or accurate match of the payment and use of medical services. A common "cost shifting" occurs when an insured patient is charged more to cover free services provided to an uninsured patient. This paper documents the multiple negative consequences of the many categories of cost shifting, reviews forces which are leading both to an increase and decrease in the magnitude of cost shifting, and evaluates the consequences of cost shifting on the goals of U.S. health care reform and investment in medical technology. Policy to minimize the negatives consequences of cost shifting is recommended.