Health Care Reform–How about more detail?

As the NY Times notes it will be difficult to reach the cost cutting goals offered by doctors, hospitals, drug makers and insurance companies. ($2 trillion in cost reductions over 10 years)

Medicynic didn’t hear that drug companies were cutting prices rather they volunteered to decrease the rate of increase. Huh? If your drug costs more than you car, or more than your salary such cost cutting will have little impact. Nor did they come out and support the notion that comparison of different approaches would improve care and cut costs.

Medicynic didn’t hear insurance executives volunteer to match the administrative efficiency of other industrialized nation’s insurance plans. Rather they promised to “end certain underwriting practices, like refusing to cover individuals with pre-existing conditions or charging women higher rates than men.”

According to Mckinsey we spend in the range of 30% of health care expenditures on administration. This is nearly $500 per capita, “five times the average level across 13 other countries.”

Medicynic didn’t hear hospitals promise efficiency and cost consciousness. There was nothing noted about geographical differences in costs and utilization but hopefully that will be on the table.

Medicynic, a retired physician, has great sympathy for physicians. They are part of the problem but an essential part of the solution as they control health care resource usage. Unfortunately, in the past, physician fees have been the simplest way to cut costs and many have been unfairly squeezed by previous cost containment efforts. Seeing patients at a loss as primary care physicians do for Medicare and Medicaid patients distorts the fee system–they need to make more elsewhere in the system to compensate. A system that pays more for procedures encourages over-usage.

Physicians have traditionally not considered cost when recommending therapy. This obviously needs to change and comparison studies offer the best way to evaluate cost efficacy.

What I saw was a photo-op, what I heard was rhetoric without commitment; a NIMBY- like approach that is not likely to crowd any of the participants bottom line–except, I would guess, physicians.

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