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Health care costs: No control
Key Excerpts from Article on Website of New York Times blog
Posted: August 23rd, 2009
http://prescriptions.blogs.nytimes.com/2009/08/12/questions-...
[Anne Underwood:] President Obama hopes to increase the number of Americans with insurance and to rein in costs. Do you believe any of the plans under consideration by Congress will accomplish those goals? [Dr. Marcia Angell:] They wont, and thats the essential problem. If you keep health care in the hands of for-profit companies, you can do one or the other increase coverage by putting more money into the system, or control costs by decreasing coverage. But you cannot do both unless you change the basic structure of the system. Q. Segments of the health care industry pharmaceutical companies, for instance are promising to cut costs. A. Its not going to happen. These are investor-owned companies. Their fiduciary responsibility is to maximize profits. If they behaved like charities, heads would roll in the executive suites. Q. But what about market mechanisms for reducing costs? Wouldnt the public option, for instance, provide competition for the insurance companies? A. Theoretically it would, but I doubt the public plan will pass. Industry is lobbying against it, and the president has not said this is a must. Even if it does pass, Im afraid the private insurance industry will use their clout in Congress and they have enormous clout in Congress to hobble the public option and use it as a dumping ground for the sickest while they cream off the young and healthy for themselves. Q. How? Wont insurance companies have to cover all applicants regardless of health status? A. Its hard to regulate an enormous industry without setting up a bureaucracy to oversee it. Thats very expensive and creates a whole new set of problems.
Note: Dr. Marcia Angell is a senior lecturer in social medicine at Harvard Medical School and former editor of The New England Journal of Medicine. A longtime critic of the pharmaceutical industry, she has called for an end to market-driven delivery of health care in the United States. To read a two-page summary of her critique of market-driven health care, click here.
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