Even though a major obstacle to agreement on the health care reform bills is their price tags, cost control is not being seriously confronted, writes Daniel Callahan, editor of the Health Care Cost Monitor, this week in The New England Journal of Medicine.
“Although everyone bewails rising costs, the constituency for doing something about them is skimpy,” he says in his essay. The essay was also the subject of a post on Forbes.com by Matthew Herper.
“What would be good enough?” Callahan writes. “A way must be found to resolve a basic dilemma: cost controls that are likely to be politically acceptable will not be very effective, and what might be effective will not be acceptable.”
Callahan recommends paying close attention to techniques used in other countries to control costs: “Some of them set limits on care that doctors consider necessary, and most require the strong hand of government: for instance, price controls on pharmaceuticals, negotiated physicians’ fees, caps on hospitals’ annual budgets, and limitations on the introduction of new technologies…They should be pushed.”
The Forbes.com post notes: “Callahan’s editorial comes the same day the chairman of the Senate Finance Committee, Sen. Max Baucus, said the group has figured out how to cover the costs of its still unfinished health care reform bill.”
—Susan Gilbert
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One Comment
The idea that it is possible to develop a 21st century health care system without some rationing is beyond bizarre. Over the last hundred years our health care has changed from being about accidents and infections in the body as a whole to dealing with defects in our 200 tissues, 22,000 genes, and 100,000 proteins. It is possible that in the very long run, when most of the medical science that needs to be done has been done, dealing with those defects might indeed be cheap. But how could anybody think *for* *one* *minute* that the government has the revenues to pay the initial cost of providing such care in its initial phases — ie, today and tomorrow — for everyone in the nation is simply beyond my powers of imagination. A couple of days ago I got a press release from a medical sciences research institute announcing they had developed a way to specialize tissue glues so that every tissue would have its own specific glue. A good thing to have for lots of reasons, but can you imagine what this will do the price of tissue glues? Etc., etc.