Dan Callahan has a good perpective piece at the New England Journal web site pointing out how difficult it will be to control costs in health care. Two quotes worth pulling out:
“Cost controls that are likely to be politically acceptable will not be very effective, and what might be effective will not be acceptable."
“Achieving [decreased growth of costs in health care] will require nothing less than changes in medical and professional values, patients’ demands and expectations, industry profit seeking, research aims and aspirations, and the culture of American medicine.”
Callahan goes back to the December, 2008 Congressional Budget Office menu of 115 ideas to lower health care costs. Callahan highlights the (painful) fee reductions that look most promising in that document. Bundling payments (or even capitation) also figures in the CBO options – and might be more promising. Massachusetts’ health care payment reform commission recently proposed a transition away from fee-for-service payment. More on this in the next post.
