Ideas for health costs |

Ideas for health costs

Joy Warren
Vail, CO, Colorado

We can all agree (regardless of party) that the current health care system is out of control. The remedy: cost control.

Maybe we could also agree that the following three ideas need to be incorporated in any legislation.

1) No one wants to tie the hands of their doctor and limit his ability to offer you the best in care. You rely on his judgment. But I suspect you would expect that judgment to be informed — informed by the best information available on the success-effectiveness outcomes of the selected procedure.

If your doctor chooses an approach that is an “outlier,” he may have a good reason. But this is information that should be readily available, and part of your decision before agreeing to your treatment.

Defining this database of information will not be without challenges. But should that preclude the effort? and could it not avoid a treatment procedure that is not only less effective but possibly more costly?

2) Have you ever bought a new dress or suit, or planned a vacation without assessing the benefits and related costs? Have you ever wondered what the costs of the tests the doctor just prescribed, but didn’t think it appropriate to ask — actually didn’t think you’d get an answer.

Here is a recent situation I confronted: I had a pain in my neck and shoulders. The doctor says his clinic needs to X-ray my neck. I say my chiropractor already did that, and I know I have a dislocation in C-5 and C-6.

He says for his “peace of mind,” let’s do more, and I say OK. But I’ll bet I might have thought a little longer if I knew the cost of those X-rays, and that I might have a financial cost or benefit in the decision. Can’t we get this built into a reformed health care system Can’t we take a part in controlling costs?

3) Finally, I liked the Cleveland Clinic example which eliminates the fee for service and pays our doctor s a salary for their high-quality care. Our doctors are well intended and highly motivated (at least I like to presume so). So why should they have to get paid piecemeal? And why should they take a deduction in pay if they would like to confer with another specialist about your treatment?

Fee for service has a longstanding history, but that doesn’t necessarily make if the best approach, does it? Might costs not be better controlled by removing the possibility that some unnecessary tests are run with a financial motivation?

I know health-care reform is complicated and can’t be boiled down to three simple ideas. I know a lot of my friends talk about the prospect of declining care, and horror of horrors — socialized medicine!

But it seems to me that there must be a myriad of ideas that could make the system work better. It must be, if I can think of three. So let’s continue the discussion and discontinue the doomsday perspective.

Joy Warren


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