In the US, Medicare is doing negotiation for meds for those in the program. There is talk about expanding that bargaining.
The ACA was trying to get people into primary care early. I'm not sure how big of an impact that made. At least in my experience, the primary care is hard to get on short notice in my area - takes 1-4 weeks depending on different things. One big seems to be that the offices Tru to increase throughput and keep their schedule booked solid to make money based on what the insurance will pay per visit (eg maximize visits). I wonder how NZ deals with the availability part if prices are set. I would think the incentive would be similar.
The funding for primary care comes from a bunch of places in NZ, but most of it comes from the government. Most people in NZ don't have private healthcare insurance, it's just not needed.
The way it works is patients 'enroll' with a doctors office, and then the clinic gets funding based on that patient population (how many patients, what sort of patients, etc). GPs still set their own fees ontop of that, but it's usually not much (like $20 USD), as they're competitive.
There isn't really an incentive to maximize the number of visits, the goal is to maintain a good patient population, who's satisfied with your services.
The average book size for an individual doctor is about 1000 people (might have gone up a bit by now). But I found that number quite interesting, as it lets you frame the job of a doctor quite differently - their job isn't just to take appointments as they come, their job is to keep about 1k people healthy. It lets you think about how else that problem could be solved.
Seems like they have as many or more here in the states, at least where I am. I see some stats that it's about 20 patients a day. I almost always end up at urgent care because they don't have enough availability at the primary in my area. The urgent care isn't covered by my insurance because they say there's enough covered providers in the area already. When I have a fever of 103F for 5 days and think it's time to investigate antibiotics, I want an appointment within 24 hours, not 5 business days from now. It seems the insurance payout and keeping the schedule booked solid drive the (under)staffing in my areas. Although it hasn't been like this in other areas I've been in, but that's more than 10 years ago now.
In the US, Medicare is doing negotiation for meds for those in the program. There is talk about expanding that bargaining.
The ACA was trying to get people into primary care early. I'm not sure how big of an impact that made. At least in my experience, the primary care is hard to get on short notice in my area - takes 1-4 weeks depending on different things. One big seems to be that the offices Tru to increase throughput and keep their schedule booked solid to make money based on what the insurance will pay per visit (eg maximize visits). I wonder how NZ deals with the availability part if prices are set. I would think the incentive would be similar.