Tuesday, July 21, 2009

"High Quality, Equitable Care For Every American, That Should Be Our Goal." -Maggie Mahar

This is a follow-up to my post Health Care: How Much Is Too Much To Save A Life? It does look like plans are being made for some rationing, among other things.

According to Health Beat's Maggie Mahar1 in her article yesterday which dissected that $1.6 trillion price tag to reform healthcare over the next ten years...
Putting the Cost of the Democrats’ Plans for Reform in Context
... the spending cuts and projected savings in House and Senate plans aren't getting enough attention. They should, because they get to the root of the problem:
"Health-care inflation, driven in large part by over-use of advanced medical technologies, is the real threat to the economy. ... Tests and treatments that provide little or no benefit to the patient — while exposing him or her to needless risks — are making healthcare unaffordable."
From the article - a few spending cuts detailed in the 1018-page House bill (1018 pages - that's a lot of bill):
  • It gives both Medicare and the public sector plan the power to reset reimbursements based on how much the treatment benefits the patient. ... Medicare could [lower] fees for those treatments that provide less benefit. ... patients could be required to pay for at least a portion of the additional costs of clinically less effective treatments.

  • It encourages primary care — which is almost always less expensive than specialists’ care. ... It would raise Medicare payments to primary care physicians by at least 5 percent ... by 10 percent in areas where there is a serious shortage of primary care doctors.

    One reason that European medicine is more affordable than U.S. care is that patients receive far more primary care, and see many fewer specialists.

    In addition ... private insurers will no longer be allowed to charge co-pays for preventive care.

  • It recommends that all manufacturers of drugs and devices be required to report their financial relationships with physicians, pharmacies, hospitals, and other organizations.
I like all of those: more money to primary care docs, no co-pays for preventative care, more visibility with drug companies, and more selective coverage for less effective treatments. This last one is a hot topic, but it needs to be debated. There are some tests and treatments that in my mind just aren't cost effective.

Here's Dr. Mahar talking (for less than a minute) about reforming Medicare, "so that Medicare is paying for effective care." (If you're too young for Medicare and thinking this doesn't apply to you, consider that Medicare will serve as the model for just about any proposed public program.)

1 Dr. Mahar is author of Money-Driven Medicine: The Real Reason Health Care Costs So Much, and Bull! A History of the Boom, 1982–1999. She has written for Institutional Investor, The New York Times, Barron's, and Bloomberg. She is a former Yale professor and current fellow at The Century Foundation.

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