Cost Containment in Health Reform–Not this reform

Alain Enthoven has a review of the problems of cost containment.

Ultimately the reason we need health reform is because our costs exceed our ability to pay. The current bill doesn’t approach this issue. It is more a bill designed to protect the income and profits of the current players than to reform it.

Enthoven’s solution:

What should be done? I explained it in my “Consumer Choice Health Plan” articles in the 1978New England Journal of Medicine. The idea is also in a recent report by the Committee for Economic Development (CED). The general idea is for government to pay everyone’s way into the purchase of an efficient or low-cost health plan, meeting standards in their state or region but no more; if people want something that costs more, they must pay the difference with their own net after-tax dollars. Additionally, the creation of exchanges that broker multiple choices of health plans would drive the delivery system to produce better value through consumer choice and competition.


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