How to Rein In Healthcare Costs
Mortimer B. Zuckerman
Medicare and Medicaid are zombie entitlement programs that threaten the U.S. fiscal future
Babies become old men and women. Of course! We know it as a biological fact. We know, too, that from 1946 to 1964 there was a postwar boom in babies. Still, it is something of a shock to realize that beginning
The baby boomers are a critical element of the explosion in healthcare costs -- but not the only one. The projected increases in
By the mid-2030s, the 65 and over population will nearly double. By then, their healthcare costs may be completely out of control, resulting in a tidal wave of federal spending to sustain these programs. At the end of fiscal 2010, medical programs for seniors made up the bulk of the government's total unfunded liability -- estimated at
All the (true) scary projections about America's long-term fiscal imbalances demand a fundamental change in how we manage healthcare. The costs are at the core of the impending fiscal crisis, which is bad enough, but the consequence isn't just a tide of red ink. Unless we get the costs under control, we will be confronted by a crippling inability to invest in other areas of national need.
What can be done?
This is where we must focus our efforts. We must stop the epidemic of procedures that neither the patient's needs nor the results can justify. Orszag offers evidence for this assertion: Renowned institutions like the
Two forces work against that kind of rational approach. The first is the litigation doctors fear if they think about good medicine and the particular patient rather than follow "customary practices." Doctors who avoid unnecessary tests and follow evidence-based guidelines for specific illnesses or conditions put forth by professional associations must have a safe legal harbor.
Second, we should change the fee-for-service payment approach that dominates our system. It doles out separate payments for everything and everyone involved in patient care. It rewards doing more over doing right. It increases paperwork and duplication, and discourages clinicians from working together. In other words, all the wrong incentives.
We should have a payment system that reflects a fee-for-value approach, that drives quality rather than quantity, and that will not serve as an incentive for unnecessary care. Today doctors can order expensive tests because it is profitable and provides a potential defense in a lawsuit. The patient has no role and there is no room to question these decisions. We have to overhaul the entire medical structure.
That can only happen if
Let's face it.
What we now have is a zombie social program, unsustainable without giant tax increases, huge cuts in benefits, or cuts in payments to hospitals, nursing homes, outpatient facilities, physicians, and homecare providers. The waste is enormous, estimated at between 30 and 40 percent of the total cost. There cannot be billions of dollars of general waste and no specific waste. The only way to cut healthcare costs is to cut healthcare costs.
Health insurance companies have to be part of the drive.
They are basically unregulated de facto monopolies in most states, with one or two companies controlling
80 percent or more of the market. Former president
The public understands this.
All the polls suggest they came to a common-sense conclusion that we could not maintain the quality of healthcare, expand coverage to all, and yet lower the cost. People know that soaring healthcare costs inevitably shift government priorities away from everything else, be it schools, roads, higher education, lower taxes, police and national security, all just to preserve the income of doctors, hospitals, insurers, and other providers.
Some higher taxes may be inevitable, but a doubling or tripling of taxes for working-age families is neither economically sensible nor politically feasible. And yet, if trend lines continue,
The first three words of the Constitution are "We The People."
Ultimately, "we the people" must take responsibility for what happens, and this applies to the fiscal future of the country as well.
Available at Amazon.com:
- Shortchanging Our Paychecks
- Unemployment Drops Sharply in October
- Recession Fears Fade But Euro Debt Crisis Still Looms
- Haves and Have-Nots: Cities with Highest and Lowest Poverty Rates
- Is the Economy Better Off Without Washington?
- How to Rein In Healthcare Costs
- Why Mortgage Rates Are Rising
- Industry Must Do its Part to Educate Workforce of the Future
- Jobs Council Issues Growth Proposals, Acknowledges Dysfunction
- September Jobs Report a Pleasant Surprise
- US Economic Woes Put China in the Political Crosshairs
- A Devalued Renminbi Makes Wealthier Americans
- Sluggish America Can Still Be a World Leader
- Behind Europe's Debt Crisis Lurks Another Wall Street Bailout
- United States - South Korea Trade Deal Win-Win for Jobs and Economy
- Obama's Trade Deal Delays Have Cost Jobs
- Reconsider Dodd-Frank, Piece by Piece
- Dodd-Frank Brings Transparency to Financial Industry
- Dodd-Frank is More Right than Wrong
- Dodd-Frank Is a Counterproductive Mess
- Repealing Dodd-Frank Would Put the Economy in Danger
- A People's History of the Great Recession
- Job Destroyers Don't Deserve Tax Holiday
- What the Recession Has Done to the Rich
- Pot Calls Kettle Risky: The Wit and Wisdom of Tim Geithner
- New Layoffs Are Harbingers of Broader Economic Changes
- Is Obama's National Infrastructure Bank the Answer on Jobs?
- We Are In a Modern-Day Depression
- Dunkin' Donuts, McDonald's Franchises Warn of Job Cuts
- Despite High Unemployment, Millions of Job Openings
- How Renters Could Save the Housing Market
- How Low-ball Appraisals Are Limiting Housing Recovery
- The Moral Question
- Rise of the Renminbi as International Currency
- United States Woos Foreign Shoppers to Boost Sagging American Economy
- How to Create More Jobs by Lowering Wages: Texas and America
- 15 Stunning Statistics About the Jobs Market
- Training Unemployed for Specific Jobs Could Solve Many Problems
- Housing Slump Will Hurt Economies Well Into Future
- Can the Government Help the Housing Market?
- Are American Consumers Relapsing Into Debt Addiction?
- Obama Deficit Plan Could Derail Hopes for Super Committee Success
- Raising Retirement Age: Reflection of Our Evolving Economy
- Why Math and Science Education Means More Jobs
- A Good Fight
- America's Government Contracting Bonanza Bilks Taxpayers
- Two Cheers and One Jeer for the American Jobs Act
- Obama Jobs Plan Seems to Get a Boost From CBO Chief
- Will Obama's Jobs Plan Help Small Business Hire More?
- More Americans in Poverty Than Ever Before
- Why Consumers Aren't Spending
- Republicans Keep Helping Wall Street and Banks Over Main Street
- 5 Political Lessons of the Economic Downturn
- First Medicare, Now Paul Ryan Tackles Tax Code
- GOP Economic Plan Unlikely to Find Much Common Ground With Dems
- With Poverty on the Rise, This is No Time to Slash the Safety Net
- Vote on Disputed Trade Bill Could Be Hitched to Jobs Retraining
- Obama Vows to Do Away with Millionaire Tax Cuts and Reduce Deficit
- Has the Housing Market Finally Found Its Footing?
- Fed May 'Twist' Balance Sheet to Promote Recovery
- In Jobs Speech, Obama Passes the Buck to Congress
- Refinancing Out of Reach for Many Americans
- Self-employed Americans Down by 2.1 Million
- Government Needs to Help Job Creators and Middle Class Consumers
- Back to School and Deeper in Debt
- Will Obama Sabotage Jobs Plan With Job-Killing Free-Trade Agreements?
- Don't Fear the Double-Dip Recession
- Five Key Economic Battles Await Congress
- Feeling Stressed About The Economy? You're Not Alone
- Building an Infrastructure Builds Jobs
- Is Infrastructure the Answer to America's Jobs Problem?
- Investing in Education Is Smart Business
- STEM Education - It's Elementary
- We Need a Bold Jobs Bill to Stop the Double-Dip
- Could QE3 Help the Economy?
- What Kinds of Federal Spending Create the Most Good Jobs?
- Who's Worse Off: Europe or the United States?
- China and the United States' Debt
- Jobs Issue Plays Into Defense Cuts Argument
- Economists Forecast 2.3 Percent Growth Rate
- Why Standard and Poor's Had to Downgrade
- Who's Next on Standard and Poor's Chopping Block?
- Who Stands for Americans?
- Has The United States Economy Turned Into a Pyramid Scheme?
- Defense Industry Threatens America's Economy
- America Downgraded!
- What Standard and Poor's Ratings Downgrade Means
- The Disconnect Between Stocks and the Economy
- How the Government Is Killing Job Creation
- Along with Lack of Jobs, A Wage Problem
- Jobs Picture Better Than Expected Except for Government Workers
- What The Economy Looks Like at Stall Speed
- Is a Double-Dip Recession on the Horizon?
- Job Numbers Go From Grim to Ghastly
- Cities Where the Job Outlook Is Improving
- Obama Should Take a Lesson from George H.W. Bush
- The Only Social Security Reform Worth Considering
- Crisis of Confidence: Debt Debate Erodes US Global Standing
- Global Economic Downturn: A Crisis of Political Economy
- The Rise of the Wrecking-Ball Right
- Housing Starts Are Up, but Don't Cheer Just Yet
- Could the Employment Picture Be Better than the Government Reports?
- Many Ideas for Job Creation, but Little Action
- Eliminating Mortgage Interest Deduction Could Further Hobble Housing Recovery
- New Mortgage Limits: Another Hurdle for the Housing Market?
- Markets Spike on Bernanke Talk of 'QE3'
- Can 'Gang of Six' Save the Day on Debt Ceiling?
- Do We Need the Debt Ceiling?
- European Debt Crisis: Could Italy Be Next?
- It's Back! The Misery Index Rides Again
- The President's Jobs Plan
- Budget Debate Has Troublesome Historical Underpinnings
- 4 Bright Spots for the American Economy
- Job Growth Dismal, Unemployment Hits 9.2 Percent in June
- Why Small Businesses Aren't Fueling Job Creation in This Recovery
- Public Sector Job Cuts Threaten Economic Recovery
- Handling Big Contradictions
- How the Crippled Housing Market Affects Job Seekers
- Think Startups are Fueling the Recovery? Not So Much
- Tax Havens: Shady Deals
- As The 'Mancession' Peters Out, The 'Race-Cession' Is Still Going Strong
- Obama Trains Spotlight on Flailing Economy
- Strategic Petroleum Reserve Release Could Give Brief Economic Stimulus
- What to Watch for As QE2 Ends
- How Health Care Can Save or Sink America
- Crude Predicament: The Era of Volatile Oil Prices
- Financial Rebalancing Act: Stop Worrying About Global Flow of Capital
- Globalization and Unemployment
Available at Amazon.com:
How to Rein In Healthcare Costs | Politics
(c) 2011 Tribune Media Services, Inc.