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Evening Ethics Discussion Group, 2007

2007

• January: How Do We Manage and Share the Cost of Healthcare?   

How Do We Manage and Share the Cost of Healthcare?

Cassel and Brennan write, “The Physician’s Charter on medical professionalism maintains that among other responsibilities, physicians must be committed to managing medical resources.  This responsibility is controversial largely because it can be seen as in conflict with the more traditional altruistic commitment of the physician to the patient.  Moreover, control of cost is inextricably linked to the business interests of insurers.  Physicians ask, is this really our responsibility?”  The authors say yes: “Physicians cannot afford to ignore the profound logic of the link between care for individual patients and the costs of care.  The more care costs, the more likely many individuals will be without good insurance, and research clearly shows their health will suffer.  It is impossible to avoid the fact that physicians live and work in a medical commons and bear responsibility for it.”

The NY Times article thoroughly identifies areas where costs are unnecessarily high and outlines ways to reduce them.

Most experts agree that cost, access, and quality are tightly linked and, in some ways, in tension with each other.  All three must be considered to evaluate changes in the healthcare system.

Articles:

1.Cassel, CK & Brennan, TE. "Managing Medical Resources." JAMA. June 13, 2007. Vol. 297, No.22.
2."The High Cost of Health Care."  The New York Times. November 25, 2007 Sunday.
3."Straw Man Proposal for Health System Reform." 9/24/07 working draft.

Questions we’ll address at our discussion include:

1. Which cost-reducing strategies in the NY Times article do you think would have a positive or, at least, no negative effect on quality and access?
2. The Salt Lake Chamber of Commerce framework for healthcare reform offers some increased access with personal responsibility and consumer choice reminiscent of the Massachusetts Plan.  What effects would you anticipate on cost and quality?
3. Is there a right percentage of our GDP that should be spent on healthcare?

We will invite individuals to our discussion who have a special interest in our topic.   We look forward to seeing you and hearing your thoughts.