Get serious about cutting costs
The Business Roundtable's latest report, Health Care Reform: Creating a Sustainable Health Care Marketplace, estimates that per-employee health-care costs will grow from about $10,000 in 2009 to over $28,000 in 2019. With the legislative proposals' tactics for cost-containment, the 2019 number would be around $25,000. That's not much of a cost-bend over a decade. Money is being wasted in the system, both clinically and administratively.
What's missing from health reform is a bolder, more comprehensive approach to managing costs. If the U.S. wants to reach universal coverage -- a goal embraced by most Americans, in theory -- it can only be done in a sustainable, responsible way by more directly dealing with costs.
While cost-containment is a theme in Senator Reid's bill, I'd like to see more forceful language in the areas of rewarding adherence to evidence-based medicine, and doing more than piloting programs for changing payments to providers. As electronic medical records penetrate physicians' practices, we'll be able to better measure quality and outcomes and pay providers based on this quantitative evidence of quality.
At the same time, a final bill should have innovative, transparent incentives that motivate Americans to live more healthfully, bolstered by an infrastructure that brings transparency to pricing, quality and outcomes information for providers and plans.
Accountability for both providers and patients will underpin a sustainable health system. But Congress isn't acting as boldly as it should.
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