Monday, January 30, 2012

Getting Health Care Providers to Reduce Cost 

During a recent conversation about the health care situation, a physician friend said that he could not remember ever ordering a test or making any other medical decision for the purpose of increasing his income.  Knowing him to be an honorable, conscientious person, I said that I believed him but then went on to ask whether he could remember ever having looked back over the previous week or month and asking himself whether there was anything he had done that might have been done less expensively without compromising care.  He couldn’t remember ever having done that. 

His answer didn’t surprise me.  Why should he spend time or energy considering possibilities that would benefit neither him nor his patients? 

The lesson here is that our health care providers have never seriously pursued cost reduction because they have never had any reason to.  That is partly due to the fee-for-service system, under which the more you do the greater your income.  It is also due in part, I think, to the general fear on the part of the public that the cost of care might be reduced by not providing needed services or by reducing quality. 

I am convinced that only the providers of health care have the ability to find ways to reduce cost while maintaining quality.  But they won’t do it until they need to.

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