As I have mentioned previously, the extension of health insurance to all Americans by 2013, as proposed by President Obama, will, by itself, do nothing to control the escalating costs of health care. Rather, by increasing demand without correspondingly increasing supply, there is every reason to believe that it will put additional upward pressure on the cost curve. A point of general agreement among health care economists is that the prevalent fee for service model for the delivery of physician, hospital and other professional services is a significant source of the cost problem. This model gives strong incentives to providers to direct patients toward more, and more intensive, services, and for both patients and providers to select services and procedures that have any possibility of a marginal positive result, even if the cost is vastly out of proportion to the possible benefit. Further, economically speaking, the patient and the payer (whether the government or private insurance co...
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