Lowering Health Care Costs

Q.	Who should play the lead role in lowering health care costs?

Health Care Experts Legislators  6% Physicians/Health Care Delivery Systems  36% Citizens  12% Employers and Purchasers  24% Insurance Companies  9% All of the Above  12%  > Legislators “Legislators must take the lead since they currently own the payment system and methods.” > Physicians/Health Care Delivery Systems “Although the other groups have potential to lower costs, physicians and health care delivery systems . . . have proven that, even without a comprehensive national plan, costs can be lowered while delivering a high level of care.” > Citizens “First, each individual citizen can do a ton to solve this crisis by living better. . . . Most avoidable health problems are far more dependent on lifestyle than health care. So the question of ‘what can you do for your country’ could be answered by making healthy life choices and doing all you can to help your neighbor do the same.” > Employers and Purchasers “Health systems can’t change until the payment systems do.” > Insurance Companies “The health insurance industry has the data, broad perspective, and management skill base to lead this effort. In addition, this would be an exceptional opportunity for this industry to do good things and repair its image.” > All of the Above “Lowering health care costs will require all parties to play a role.”

Executives Legislators  21% Physicians/Health Care Delivery Systems  33% Citizens  15% Employers and Purchasers  21% Insurance Companies  9% All of the Above  0%  > Legislators “Everyone has an axe to grind in this debate, but at least legislators are getting counsel from all of the other groups. I just hope that the group that speaks the loudest . . . hasn’t clouded the vision of too many of our legislators.” > Physicians/Health Care Delivery Systems “In our manufacturing business it is not our customers that will lower our costs. We ourselves have to take the responsibility to make that happen. Our customers may push us and ask for lower costs or more services for the same money, but if we the manufacturer don’t work at cutting costs it just will not happen.” > Citizens “It’s easy to say that each of us should be responsible for our own health care, particularly understanding the value of it, but extremely difficult in practice. . . . But if each one of us doesn’t take more responsibility, health care will continue on its parlous path.” > Employers and Purchasers “By demanding innovative, cost-effective products and services delivered by physicians and insurers, they will have the most influence over what will work long-term because they are paying for it.”

Summary At a time when our nation is about to change how 17 percent of our gross domestic product functions, there is no agreement on who should take the lead in lowering health care costs. It is the most fundamental question Congress is facing—no wonder they can’t get agreement on a bill! The group getting the largest number of votes is physicians and their health systems. Has anyone told the physicians our nation wants/needs them to take the lead in lowering health care costs? Have we trained them to do this? Most physicians are not even fluent in what a procedure or drug costs their patients. Furthermore, asking physicians to take the lead in lowering health care costs will likely directly lower their personal income—again, no wonder this is our nation’s number one domestic dilemma.

Comments

[Jon McGuire]

So, what to do? Increase the integration of insurer, insured, provider, and legislator, so that everyone is viewing the same picture. Then, as most believe from the survey here, let the providers (or some representative group who doesn't stand to benefit monetarily from any outcomes) make the decisions (under advice of counsel, et al). This way we have the people who understand the problems on a local level making decisions with a global perspective. Ideally that is the way any system works, and I think that some of the very best entrepreneurs have taken such a path on their own (author of the article included), and have been able to affect positive change in small pockets. The issue is systemic however, and from time to time the system needs to be redesigned. You wouldn't use the original DOS to run Windows 7 would you? DOS doesn't even exist anymore in the way we once knew it, and everyone knows that system could never handle the complexity of problems that modern day computing requires, yet here we are, running the same healthcare system we have had for... oh I don't know, let's say 2 decades to be conservative.

[Dee Thibodeau]

This is extremely interesting. If we do not get together on this and decide who is leading this, it will not get done! Since the legislators are the ones who own the payment system and methods, we need to start with them and work with all of the other groups. Not to be involved will result in no action which is the wrong decision.