Resisting the Dream of Markets: Maryland’s All-Payer Hospital Rate-Setting System and the Persistence of Regulation in U.S. Health Care

Maryland’s system has undertaken important new policy experiments that are now expanding to other states, suggesting at least partial reversal of the market-orientation that has dominated U.S. cost control efforts for the last three decades despite a striking lack of success. This essay traces the evolution of the Maryland system and places it in the wider context of the U.S. health system and regulatory environment.