: : : : : Health Report : : : : :
care costs skyrocketing? Ginsburg and
others point to all those fancy medical
technologies we now rely on (think
MRIs and CT scans), as well as our fee-for-service payment system, in which
doctors are paid by how many patients
they see and how many treatments they
prescribe, rather than by the quality of
care they provide. Some experts say
this fee-for-service payment system
encourages overtreatment (see “Why
Does Health Care Cost So Much?”
from the July–August 2008 issue of
AARP THE MAGAZINE, at aarpmagazine
.org/health/ health_care_costs.html).
“There are many ways to tackle our
health care problem, but we will come
up with a uniquely American solution.”
supports research on health care practice and policy, estimates that health
care reform will cost roughly $600
billion to implement but by 2020 could
save us approximately $3 trillion.
” My access to quality health
care will decline.” Just be-
cause you have access to lots
of doctors who prescribe lots of treat-
ments doesn’t mean you’re getting
good care. In fact, researchers at Dart-
mouth College have found that patients
who receive more care actually fare
worse than those who receive less care.
In one particularly egregious example,
heart attack patients in Los Angeles
spent more days in the hospital and
underwent more tests and procedures
than heart attack patients in Salt Lake
City, yet the patients in L.A. died at
a higher rate than those in Salt Lake
City. (Medicare also paid $30,000 for
the L.A. patients’ care, versus $23,000
for the care of the patients with better
outcomes in Salt Lake City.)
“Reforming our health care
system will cost us more.”
Think of health care reform as
if it’s an Energy Star appliance. Yes, it
costs more to replace your old energy-guzzling refrigerator with a new one,
but over time the savings can be substantial. The Commonwealth Fund, a
New York City–based foundation that
“I won’t be able to visit my
favorite doctor.” Mention
health reform and immediately people worry that they will have fewer options—in doctors, treatments, and
diagnostic testing. The concern comes
largely during discussions of comparative effectiveness research (CER):
research on which treatments work
and which don’t. But 18 organizations
in a broad coalition, including AARP,
NFIB, Consumers Union, and Families
USA, support CER—and believe that
far from limiting choices, it will instead
prevent errors and give physicians the
information they need to practice better medicine. A good example: Doctors
routinely prescribe newer and more
expensive medications for high blood
pressure when studies show that older
medications work just as well, if not
better. “There is a tremendous value in
new technology, but in our health care
system we don’t weigh whether these
treatments work,” says Feder. “
Expensive treatments replace less expensive
ones for no reason.”
“The uninsured actually do
have access to good care—in
the emergency room.” It’s
true that the United States has an
open-door policy for those who seek
emergency care, but “emergency room
care doesn’t help you get the right
information to prevent a condition or
give you help managing it,” says Maria
Ghazal, director of public policy for
Business Roundtable, an association of
CEOs at major U.S. companies. Forty-
