Comments on: We need health care reform

By: Michael Kirsch, M.D.

Michael Kirsch, M.D. — Thu, 04 Feb 2010 21:44:14 +0000

I am not certain that the Democratic plan is really better than the status quo. I think their plan made significant inroads on expanding access, but failed in controlling costs. To accomplish the latter, various stakeholders would have to sacrifice income, careers and companies. Not surprisingly, there weren't too many volunteers. Hospitals and Pharma agreed at the outset to give back, but most of the players in the game zealously protected their parochial interests. My view is that medical overutilization should be attacked. Of source, an 'overutilized' test or treatment is someone else's income. No easy solution here. Get prepared for microreform.

By: Dr. Bob (FP)

Dr. Bob (FP) — Thu, 04 Feb 2010 21:09:29 +0000

None of the national level politicians (both D & R) have the courage to suggest things that result in real cost control. They can't do this without angering some group that contributes money. They can't cut costs without affecting some group's gravy train (Pharma, insurers, physicians, etc.) They don't think they can win votes if they tell people what they really need to hear (yes, the public is guilty of over-utilization too). I too am becoming cynical that any meaningful reform will happen on the national level. I think we'll have to tackle this on the state level.

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By: PeterW

PeterW — Thu, 04 Feb 2010 15:12:27 +0000

I should add that of course expanding insurance only exacerbates the third party payer problem that leads to escalating costs. Europe and Japan started from a lower base but now have the same rate of cost inflation as us, thanks to the perverse incentives – if my boss is paying, I'll have filet mignon.

By: PeterW

PeterW — Thu, 04 Feb 2010 15:11:08 +0000

Of course the Democrats focused entirely on expanding insurance, without doing a thing about the main issue: cost control. Everyone can agree that "reform" is needed, but many many policies fall into that box and many of them are harmful.