A Good First Step

The work by the Pharmaceutical Research and Manufacturers of America (PhRMA) and Medicare to address the Medicare Part D "doughnut hole" coverage gap is a positive step to improve coverage and accessibility of necessary drugs for Medicare beneficiaries. However, the steps taken are a form of voluntary price controls, and we have learned over the past 25 years in Medicare that price controls do not result in controlled spending, so this is not a long-term solution.

Real long-term success in reducing costs in all of health care will come through delivering the right care to the right people at the right time, using the best science and medical judgment available and shared decision making with patients -- in other words, delivering higher quality, safer health care (including pharmaceuticals) at a lower cost.

To achieve this transformation and to gain agreement among providers and other health care stakeholders to participate, they must have the right incentives. Medicare and other government-run insurance programs should be reformed so that they pay for value -- improved patient outcomes and decreased waste. Today's government-run programs pay the most to providers who use the most resources, regardless of their outcomes. This is hardly an incentive to reduce cost, and those doctors, nurses and hospitals that provide care at lower cost are punished under the current system.

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Jeffrey Korsmo

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A Good First Step