The cost of healthcare is always a major concern in the U.S. With approximately 47 million uninsured people and soaring costs, the already-beleaguered healthcare system has been a major topic of debate in this, an election year.
In “Options for Slowing the Growth of Health Care Costs” from the April 2008 issue of the New England Journal of Medicine, the authors present several options that they see as potentially cost-saving. Their “top three” picks that they believe have the greatest potential are capitation, strengthening reviews for new drugs and technology, and electronic health records.
Capitation, in which providers of care are paid a fixed amount of money to provide for the healthcare needs of a patient population, has been tried and found wanting. Providers of care have balked against caps placed on their provision of service, and patients have been dissatisfied with being unable to freely choose their own physicians. Given that it is an unpopular choice for many physicians and patients, an effort to expand capitation to more healthcare sectors will likely be an unpopular choice that will meet much opposition.
The idea of a national oversight committee to provide more effective and stringent reviews for new drugs and technology and which would be required before reimbursement was made is a sound idea in theory. However, as the authors point out, “concern about this approach comes from members of industry, who worry about the possible effects of such reviews on the time and costs associated with getting products to market.” This may be a valid point: tying up new drugs and technologies in bureaucratic red tape might unnecessarily lengthen the time it takes to get them to patients who need them. This could be a drawback if the new products have the potential to save money in the long run in terms of making patients well faster.
The authors believe that use of electronic health records can be a cost-saving strategy. “We believe the greatest cost-reducing effect of electronic health records will result from improved coordination among health-care providers and from decision support that improves clinician’s use of tests and treatments.” The major drawbacks mentioned by the authors in this study are the costs involved in implementing electronic health records into practice and, perhaps more importantly, physician’s potentially negative attitudes towards using computers to tell them how to practice medicine.
The authors suggest several potential cures for what ails the U.S. healthcare system, but will anyone be able to agree on which, if any, methods to use.
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How about living more healthfully and accepting mortality (that is to say, not being so obsessed with trying to stave off the inevitable — death)?
Anittah,
Thank you for your comment.
You raise a valid point. I agree that consumers of health care need to take responsibility for their own health care, and spend less time worrying about their medical bills. If we all lived as we should, we would have less need for medical care (and I would have nothing to write about!)
Jennifer