Here's how to control healthcare costs


If you want to know what is driving up the cost of healthcare in this country, you must read “The Cost Conundrum”

by Atul Gawande in this week’s issue of The New Yorker magazine.

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It’s fascinating, and makes a very strong case that doctors are the problem. As soon as a doctor starts thinking of himself as a businessman first and medical professional second, all hell breaks lose. He begins ordering tests and procedures that are often unnecessary. He’s starts up clinics and other ventures that drive utilization. He requires an exorbitant monthly fee to serve as a health care agency's medical director. The list goes on. Something has to change, and we can only hope that healthcare reform tackles this problem.

I’m all for controlling fraud and abuse, but after you read this story, all the emphasis CMS puts on HME fraud and abuse and oxygen reimbursement seems absurd. If they want to get to the root of out-of-control healthcare spending, they’ve got to take on the docs. These guys are not sacred cows and need to be reined in for the good of the country.

— Mike Moran


Mike, I read that article and had a different takeaway than you did. While there are some doctors who are focused solely on the business aspects of medicine for financial gain, many physicians have been forced into the mini-CEO position against their will. The essay argues that putting the patient first and removing the financial incentives in patient care has improved quality and reduced costs. When health care professionals share expertise, "you get more thinking and less testing." What works is collaboration, and taking collective responsibility. We have a greater opportunity to do this as partners to our referring physicians rather than as their adversaries.