As a private citizen, I am distressed by the cost of medical care. As a surgeon, I can identify some of the factors responsible: the public`s demand for unlimited access to state-of-the-art medical therapy, regardless of the cost; incredible liability expenses; increasingly sophisticated medical technology; exorbitant charges by some members of the health car industry.
HMOs and Medicare DRGs have been put forth as solutions because they create economic incentives to reduce cost, albeit by selectively reducing testing and restricting hospitalization. As I`ve encountered more and more unhappy HMO patients and disillusioned Medicare patients, I have become convinced that HMOs and DRGs will not reduce health care cost for an extended period, because our malpractice climate will not allow it. Unhappy patients frequently take their grievances to court, and the courts are not concerned with cost containment.
The failure of HMOs and DRGs, however, will be blamed on the greed of the private health care industry and will be used to justify the government take- over of medicine. The federal government can save money by one method only
–enforced rationing of medical care. This has been true in every socialized medical system. Many patients will be denied care because they are too old, too young, not sick enough or too sick. America must decide soon how much it is willing to pay for medical care or our government will do it for us.
