Suggestions for more affordable care

by jerry on August 04, 2019
Dr. Ezekiel Emanuel, frequently consulted as an expert on health policy, wrote an opinion piece in the New York Times outlining four suggestions to make health care more affordable. The piece starts out by framing the Democratic presidential candidates as debating the wrong question (what type of national healthcare plan should US adopt versus how do we get healthcare expenses under control). A surprising statistic is that while the US has about 4 percent of the world's population, it accounts for nearly half of the global drug spending. The US has been paying more per dose of medication than others around the world, effectively subsidizing the world's research and development of medication.

Dr. Emanuel takes aim at all the major players in the healthcare industry with a variety of ideas: national negotiations to curb drug pricing, a cap on hospital prices (he blames mergers of hospital systems as the root of soaring prices), and standardization in the insurance industry. Taken as a whole, the healthcare industry is surely not happy about his proposals; taken separately, different parts of the industry might be thrilled at different proposals. Dr. Emanuel lists a fourth option which has been gaining momentum over the last decade: shifting away from fee-for-service compensation for doctors and moving towards value-based payments (in other words, paying for patients' health and good outcomes, rather than paying for amount of work done). These are all sweeping changes that Dr. Emanuel groups as "four simple policies."