The health care system in the United States is going through significant changes but with an uncertain outcome. These changes have been anticipated for a very long time, most likely due to the disproportionate increase of health care expenditures in this country—costs that will continue to rise due to the increase in the aging population and enhancements of medical technology. The recent economic situation in the United States has not been helpful concerning this discussion; on the contrary, it has made solving this problem one of the priorities of the country. Almost everybody knows that a reduction in the costs of delivering health care needs to be addressed. This goal can most likely be achieved through rationing of care and/or reduction of payments to hospitals and medical professionals.
The major question concerns how to decrease costs without undermining the quality of care. Are we really able to reduce the influx of technology into the medical field? We know that any new progress in technology will be much more expensive than previous technology was. Are we really able to limit access to new inventions despite knowing that a specific procedure or treatment could change the outcome of the disease? If access to these kinds of technology is limited, we would have two classes of patients and medical care: One group of rich citizens could afford to pay for treatment out of their own pockets, while the other class of citizens could not afford to get better treatment despite the need for it. I doubt that we, as a society and as medical professionals, would vote for these kinds of changes in the future.
How would the reduction of payments to hospitals and medical professionals affect the current dilemma? It sounds simple to reduce payments to organizations and groups that provide care, with the goal being to reduce the costs of care.
Medicare has been lobbying for such legislation for many years. Will a reduction in payments result in any decrease in the steeply rising health care costs in the United States? How many times can Medicare reduce payments to providers without pushing these professionals to stop accepting Medicare patients permanently? If we acknowledge that health care costs will continue to rise because of our aging population and advances in medical technology, we should conclude that we cannot compensate for these factors merely by reducing Medicare payments to hospitals and medical professionals. Becoming a medical doctor in the United States is an expensive process. The anticipated salary of physicians must match the cost of their education and training, or the entire process would not make any economic sense. This simple logic shows that reducing Medicare payments to physicians cannot be a long-term, sustainable solution to halting rising costs in health care delivery.
I believe ensuring long-term, successful reductions in health care costs can only be achieved by changing the current system. We may be able to reduce health care expenditures by cutting Medicare payments to physicians and hospitals or by rationing patient care for a short time; however, these solutions will not have any long-term impacts on managing the exponential increase in the cost of providing care to the population.
In the current U. S. health care system, practicing and maintaining high-quality care is not rewarded. The meaning of high-quality care is not an abstract concept; it is based on ensuring improved outcomes, such as reducing hospital admissions and readmissions, using fewer invasive procedures, using preventative measures for diagnosing diseases and complications, avoiding unnecessary referrals and cross referrals, reducing medication errors and complications, and improving the standardization of patient care through improved guidelines, the improvement of primary-care physician training and eminence.
Changing any of the previously mentioned behaviors and processes would require a significant amount of energy and dedication. However, we must ask whether we as medical professionals and society as a whole are ready to work hard to reduce the costs of providing health care without sacrificing the quality of care and whether we are unified enough to seek a long-term solution rather than a short-term fix.