The truth about controlling health care costs … that most politicians and Americans don’t want to deal with

Managing, let alone reducing, health care costs is a challenge … to say the least. The issue is complicated, sensitive, controversial and personal. The reality is that many perhaps most people do not want to hear about the changes that are necessary. Unfortunately, many politicians take advantage of our fears and mislead us as to the cause and cure for these costs.During the health care debate Ezekiel Emanuel, Chair Medical Ethics and Health Policy, University of PA was an advisor to the administration. I read many of his papers and ideas and he made sense. He was one of the few people who explained the issues and debunked some of the popular thinking. Following is a brief excerpt from a recent article of his on The Hill. While this article deals mostly with Medicaid and Medicare, the principles apply to all health care coverage.

However, Emanuel makes the case for states to opt in for the Medicaid expansion under Obamacare. There is another side to that story, one that can have a major impact on the taxpayers in each state. Take a look at this article.

I urge you to read the full article here and then let me have your comments. I added the bold.

Probably the most important federal action will be around cost control. While health care inflation has declined, much more will need to be done if for no other reason than as part of a deficit deal. It will be too easy to opt for either cutting Medicare payments to physicians, hospitals and other providers or to enact premium control. But neither will improve the system, quality of care, and reduce costs. The real solution is to change how Medicare pays for health care—to create a schedule end to fee-for-service medicine and price setting for other medical services.

The key to long term cost control is to change how care is delivered to patients especially the high cost 10 or 15% of patients whose care consumes over 65% of costs. These high-cost patients are the chronically ill, patients with heart disease, emphysema, asthma, diabetes, cancer, and other chronic conditions. The goal is to keep these patients healthier, and out of the emergency room and hospital. The only way to do that is to deliver much more comprehensive care out of the hospital through medical teams that prevent development of problems, engage these patients in improving their own health through compliance with medications, diet, exercise, and other programs. Doing this is not trivial, it requires a re-engineering of how doctors deliver care. Fortunately, there have been successful models of this kind of transformation.

Can you disagree with any of the above?

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