NPR : News

Filed Under:

Taming High Health Costs Takes Taming High-Tech

Expensive technologies like proton beam therapy and hot chemo baths are among the reasons America's health care spending is rising at an unsustainable clip and making the federal deficit so hard to tame.

But two of the nation's top health care economists are expressing doubts that accountable care organizations — one of Obama administration's most-hyped mechanisms to save money — will be able to overcome the medical system's lust for the new new thing.

Established through last year's health law, ACOs are networks of doctors and hospitals that would collaborate to provide quality care at lower cost, with the motivation of keeping a share of the savings they deliver to Medicare and private insurers. Medicare has been working for months to get the program running by next year.

In a paper delivered last week at a Federal Reserve Bank of Kansas City symposium in Jackson Hole, Wyo., Harvard's Katherine Baicker and Amitabh Chandra warned that ACOs may not want to rein in the use of expensive technologies that haven't been proved superior to old-fashioned approaches, since the new stuff is often a major lure for patients.

They write:

[W]e do not know how well ACOs will sidestep cost-ineffective technologies, particularly if the latest shiny innovation increases market share. The viability of ACOs will depend on the receptiveness of physicians to capitated payments — some specialists will see their incomes fall and are unlikely to take these cuts quietly. While their concerns may not resonate with patients, they might if providers claim that valuable care is being withheld. Designers of ACOs are therefore keenly interested in measuring ACO performance and patient satisfaction, but current quality measures only capture truly negligent care.

The authors also warn that even if ACOs do achieve savings by performing fewer procedures, "some of the savings from lower quantities may be offset with higher prices as ACOs exert market power" by charging more to private insurers.

Their paper has the relatively snappy title of "Aspirin, Angioplasty, and Proton Beam Therapy: The Economics of Smarter Health Care Spending." It's the latest argument that's been made about the need to limit the use of fancy technology, as political accusations of "death panels" have receded for the moment.

But the Harvard professors are bleak that fixing most of America's wasteful health spending, including that on iffy technology, will be enough. They conclude:

The U.S. has yet to wrestle with the question of public policy priorities in a world of scarce resources: even with perfect productive efficiency, we cannot cover all services for all people. ... By first ensuring that health care resources are used more productively, we will be in a much better position to move towards spending the "right" amount on health.

Copyright 2011 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

NPR

Texas Bookseller Picks 3 Summer Reads

Julia Green of Front Street Books recommends Moonlight on Linoleum by Terry Helwig, City of Women by David R. Gillham and The Evolution of Calpurnia Tate by Jacqueline Kelly.
NPR

He Used To Live On The Streets Of Mumbai. Now, His Cafe Welcomes Everyone

Amin Sheikh's new cafe is a rarity in class-stratified India: It's open to people from all walks of life. Sheikh is a former street child, and so are many of his employees.
NPR

For Many Black Voters, Trump's 'What Do You Have To Lose?' Plea Isn't Enough

Donald Trump promises to help bring jobs and security to black neighborhoods. But his poll numbers with African-Americans are in the low single digits, and many say his message is insulting.
WAMU 88.5

A Cyber-Psychologist Explains How Human Behavior Changes Online

Dr. Mary Aiken, a pioneering cyber-psychologist, work inspired the CBS television series "CSI: Cyber". She explains how going online changes our behavior in small and dramatic ways, and what that means for how we think about our relationship with technology.

Leave a Comment

Help keep the conversation civil. Please refer to our Terms of Use and Code of Conduct before posting your comments.