Magazine article Medical Economics

Cost Control Myths Must Be Addressed to Fix Health System

Magazine article Medical Economics

Cost Control Myths Must Be Addressed to Fix Health System

Article excerpt

From misunderstandings about the role of healthcare inflation to cost controls in the Affordable Care Act (AC A), three economic myths must be addressed for the healthcare system to function properly, says Theodore R. Marmor, PhD, Yale University professor emeritus of public policy and management as well as political science. He recently spoke with Medical Economics Editor-in-Chief Lois A. Bowers, MA.

Two of your many books are Comparative Studiesand the Politics of Modern Medical Care and Fads, Fallacies and Foolishness in Medicare Care Management and Policy. What are the most relevant messages from them for primary care physicians today?

The biggest myth is that a country's experiences of medical inflation are proportionate to the rise in income of the country because of forces that are uncontrollable.

I've published a book on comparative studies, but people don't use comparative analysis in a very careful way. They're too cavalier about explaining why things are the way they a re. They delude themselves into thinking that somehow, the Medicare program in 1965 meant that the United States could never get to any kind of cost control because Americans have different ideas. There's no basis for that at all.

The reason we had trouble with costs by comparison with everybody else is that the inflationary forces in medical careare powerful. The question is not what citizens believe; it's the structure of political power and whether or not the countervailing forces against inflation are well-organized or not institutionally.

If you ask why Canada was different from the United States between 1970 and 201 2, it has nothing to do with Canadian beliefs. It has everything to do with the fact that there's a structure of decision-making. …

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