title: Stemming the tide of health care costs.
abstract: The government and third party carriers have concentrated their cost containment efforts in the wrong areas: reducing physician payments and restricting patients' access to care, while increasing bureaucratic administrative costs at all levels. There has been no net benefit from this cost containment effort. Shifting income from one group to another is not the solution. For those economists who require proof of this assertion, a study for validation is recommended. For one year a single state could be chosen to implement these recommendations: rapid reimbursement to avoid costly appeals; no utilization review or second opinions; no precertification; notification of patients before a procedure of the reimbursement amount; providing a percentage share of any insurance company savings resulting from physician review of itemized hospital bills; enacting meaningful tort reform to affect that 17% of physicians' costs and countless "defensive" lab and hospital expense; publishing comparative costs of common procedures by hospitals; and publishing comparative prices for common drugs by pharmacies. My hypothesis is that the costs of health care will be reduced below other states, while saving enormous "managed care" administrative costs. Dramatically reducing the huge noncaregiving costs of medicine, which make up at least 30% to 40% of the health care dollar, would enable all the uninsured and uninsurables to have the excellent, readily accessible health care they need at no increase over current expenditures. "Cost shifting" in all its many forms could be eliminated. We simply must cause a proper allocation of funds through appropriate regulation of insurance companies and their excessive administrative charges, meaningful tort reform, and the education of our physicians and the public in cost efficient, high-quality medical care.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: M S
authors.initials: MS
authors.lastname: Ellis
mesh_terms: D003363:Cost Control; D017048:Health Care Costs / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence / Q000639:trends*; D007349:Insurance, Health, Reimbursement / Q000639:trends; D017057:Medically Uninsured; D014481:United States