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Who's to blame for high health care costs?

Who's to blame for high health care costs?

Although everyone acknowledges that health care costs have soared dramatically in recent years, there is no consensus on who's to blame or how to curb the upward spiral.

Some blame new technology; some blame physicians; still others fault the Government, whose low reimbursement results in cost shifting to private payers.

Such diverse opinions were reported in a recent survey of 800 consumers, physicians, employers, and hospital executives conducted for Modern Healthcare(1) by National Research Corp., a Lincoln, Neb., market research firm. The survey is believed to be the first attempt to measure the sentiments of the four groups based on identical questions covering a spectrum of health care issues.

Disagreement was high on the question of who was responsible for rising health care costs. Some 29% of the physicians blamed new technology and equipment, while 24% of the consumers and 23% of the employers faulted physicians. Hospital executives laid most of the blame (28%) on the Government (see Figure I).

A large majority of consumers and employers (86% and 79%, respectively) said hospitals charge more than it actually costs to provide services.

On the issue of access to care, all four groups agreed that health care should be available to everyone, regardless of their ability to pay for it. Sizable percentages of consumers and employers (39% and 44%, respectively) named the Government as their first choice to pay for such a program.

On the other hand, 31% of the physicians preferred to have employers carry the financial burden rather than the Government or patients, their second and third choices.

Hospital executives were ambivalent on this question. Some 36% said they didn't know who should pay for national health insurance. Of those with an opinion, 27% said the burden should fall on the Government, while 19% thought employers should be the primary payers.

As to quality of care, 24% of the consumers and 29% of the employers believed the quality of hospital care has deteriorated during the last five years. Not surprisingly, only 9% of the hospital executives and 15% of the physicians thought so.

Finally, the survey addressed the controversial question of health care rationing if costs can't be contained. Hospital executives (57%) and physicians (46%) supported rationing by at least a three-to-one margin over consumers (16%). Employers were roughly in between at 29%. Although there was little agreement on rationing criteria, the two that gained the most support among the four groups were: 1) that a procedure is medically vital to a patient's health, and 2) the expected quality of life of a patient after treatment. [Figure I Omitted] (1)Kenkel, P.J. Pointing the finger. Modern Healthcare 20(48): 22-25, Dec. 3, 1990.
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Author:Fitzgibbon, Robert J.
Publication:Medical Laboratory Observer
Article Type:editorial
Date:Apr 1, 1991
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