Small-Group Session

We've Seen the Future: Insights About the Real Dynamics of Marketplace Competition
July 13, 2012


Judith Miller Jones, MA


In this small group session,  Ellen Zane, chief executive officer emeritus of Tufts Medical Center, shared insights into the dynamics of  health care markets and how those dynamics might affect the implementation of health reform and efforts to reduce costs and get better value for the dollars spent on health care. Some of the topics addressed during the discussion included: 

  • how leverage is used by providers and insurers in ways that are mostly unseen to those outside the system and how it creates perverse incentives and results,
  • how market realities and public policy goals do not necessarily intersect as we would like,
  • how the lack of "sunshine" on various provider and insurer transactions harms consumers and employers,
  • how inequities can drive costs and inefficiencies in the market, and
  • what "having skin in the game" really means for consumers and providers. 


Ellen Zane (bio)
Chief Executive Officer Emeritus
Vice Chair, Board of Trustees
Tufts Medical Center

Related Materials

See also two previous Forum Sessions, "Health Care Cost Drivers in Massachusetts: Lessons for Federal Policymakers" (June 21, 2010) and "Insurer-Provider Payment Negotiations: Implications for Health Spending" (December 10, 2010).

For more information about the effects of hospital consolidation see:

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