Experts Offer Solutions to Health Care Cost Containment Problem

In this election year, U.S. national spending on health care will reach $2.8 trillion, or about 18% of total spending on all goods and services. This high level of spending reduces our ability to invest in other important parts of the economy and also adds to our unsustainable national debt. There is wide agreement that we must find ways to bend the health care cost curve. Taking different approaches, the two Sounding Board articles in the current issue of the New England Journal of Medicine, by Ezekiel Emanuel et al. and Joseph Antos et al., present a range of options, including reducing both the prices and quantity of services for public and private payers, reducing administrative costs, implementing new market-based incentives, and reforming the tax subsidy for employer-sponsored health insurance. The Emanuel article contains eleven specific recommendations for reform, including aggressive use of bundled payments. The Antos article suggests a market-based approach to healthcare reform including replacing open-ended subsidies for Medicare beneficiaries with a fixed dollar, defined-contribution model. The articles are intended to stimulate discussion and debate on the best ways to address the cost problem and to place our health care system on a more sustainable path.