Comments on: Why Big Reform Should And Could Happen In 2009 http://wonkroom.thinkprogress.org/2008/11/26/cost-containment-refrom/ Thu, 26 Nov 2009 16:42:01 -0500 http://wordpress.org/?v=2.8.5 hourly 1 By: jps http://wonkroom.thinkprogress.org/2008/11/26/cost-containment-refrom/comment-page-1/#comment-3026 jps Thu, 27 Nov 2008 23:27:45 +0000 http://wonkroom.thinkprogress.org/2008/11/26/cost-containment-refrom/#comment-3026 I got your cost containment strategy right here: Have all the insurance companies who slow care down with "pre-approvals" including $15/hour clerical cubicle workers overruling the judgment of M.D.s go to work for G.M. building Volt plug-in hybrids or Vespa putting up wind turbines. I got your cost containment strategy right here: Have all the insurance companies who slow care down with “pre-approvals” including $15/hour clerical cubicle workers overruling the judgment of M.D.s go to work for G.M. building Volt plug-in hybrids or Vespa putting up wind turbines.

]]> By: flapple http://wonkroom.thinkprogress.org/2008/11/26/cost-containment-refrom/comment-page-1/#comment-3022 flapple Thu, 27 Nov 2008 05:39:02 +0000 http://wonkroom.thinkprogress.org/2008/11/26/cost-containment-refrom/#comment-3022 These may be specific proposals, but they do not really add up to an effective cost containment strategy. Expanding access looks more like wishfull thinking, group purchasing should make savings, although how much this method can be used in the US where research and other fixed costs must be covered is questionable (ie it works much better in Australia where only variable costs need to be covered). It is not at all clear that better prevention would lower costs, it may just make people live longer, have more health problems of old age and die a slow and expensive death from old age. Improving effectiveness may improve health, but it is not clear it will produce cost reductions (just aas energy efficiency does not necessarily reduce energy use), and well, the old "IT will solve everything" line has been sold in so many different industries, the world is littered with oversold IT project failures. Cost escalation is a natural side effective of having a market driven health system. With such huge asymmetries of information consumer cannot act as an effective check on health producers, and since insurance companies pay they have no incentive to do so. The keys to cost containment are simple command and control tools. Limit income growth for medical personal. Limit purchases of new equipment. Ration access to health care. These may be specific proposals, but they do not really add up to an effective cost containment strategy. Expanding access looks more like wishfull thinking, group purchasing should make savings, although how much this method can be used in the US where research and other fixed costs must be covered is questionable (ie it works much better in Australia where only variable costs need to be covered).

It is not at all clear that better prevention would lower costs, it may just make people live longer, have more health problems of old age and die a slow and expensive death from old age.

Improving effectiveness may improve health, but it is not clear it will produce cost reductions (just aas energy efficiency does not necessarily reduce energy use), and well, the old “IT will solve everything” line has been sold in so many different industries, the world is littered with oversold IT project failures.

Cost escalation is a natural side effective of having a market driven health system. With such huge asymmetries of information consumer cannot act as an effective check on health producers, and since insurance companies pay they have no incentive to do so.

The keys to cost containment are simple command and control tools. Limit income growth for medical personal. Limit purchases of new equipment. Ration access to health care.

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