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Atul Gawande Article New Yorker in the news.

Stanton Peele: The Case for Managed Health Care – and why Americans reject the U.S. employers increasingly want to cap escalating health care costs through "managed care" corresponds to the way costs are controlled in the UK – who spend half as very year as us.

Reform bills don’t cut escalating health costs, experts say

Health care reform legislation in Congress will do little to put the brakes on accelerating health costs, two experts say in new analyses.

While there is much to like in bills proposed by the House and Senate, the bills focus on expanding health care access to uninsured Americans will do little to control costs, especially in the short term, said Rob Leflar, a law professor at the University of Arkansas in Fayetteville and the University of Arkansas for Medical Sciences in Little Rock.

Dr. Atul Gawande, an influential writer and surgeon, says in a Dec. 14 New Yorker piece that “the legislation has no master plan for dealing with the problem of soaring medical costs. And this is a source of deep unease.â€

Instead, he and Leflar say, the proposals offer pilot, or experimental, programs.

As Leflar explains in an article posted on the University of Arkansas Web site the bills don’t change the current system, which pays doctors on how much volume they do — how many tests or how many surgeries they perform. Consequently, he says, Congress will have to come back later and make the tough decisions they are not making now.

Gawande writes, “The reason the system is a money drain is not that it’s so successful but that it’s fragmented, disorganized, and inconsistent; it’s neglectful of low-profit services like mental-health care, geriatrics, and primary care, and almost giddy in its overuse of high-cost technologies such as radiology imaging, brand-name drugs, and many elective procedures.

“At the current rate of increase, the cost of family insurance will reach twenty-seven thousand dollars or more in a decade, taking more than a fifth of every dollar that people earn. Businesses will see their health-coverage expenses rise from ten per cent of total labor costs to seventeen per cent. Health-care spending will essentially devour all our future wage increases and economic growth. State budget costs for health care will more than double, and Medicare will run out of money in just eight years. The cost problem, people have come to realize, threatens not just our prosperity but our solvency.â€

The House has approved its bill but the Senate is engrossed in a second week of debate, which may extend into the holidays. The Senate is stuck on public funding for abortions and whether to include a government-run public option in its bill.

The Congressional Budget Office says it expects only 3 million to 4 million to enroll in a public option health plan. Supporters say it would provide consumers with more choice, but foes say it is unfair competition for private health insurance companies.

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