Is the public ready?
Re: “Fee-for-all,” (Sept. 12, p. 6): The issue is not merely transparency but what to do with higher physician costs. Since prices for all healthcare products and services are higher in the U.S. than in other developed countries (except generic and over-the-counter medications), the one solution coming from Congress and other healthcare reformers is: Save money by lowering prices. However, decades of research studies from this and other countries clearly demonstrate that lowering prices does not lower overall cost. If fees are reduced, physicians increase the volume of services and level of technology. But reducing volume and technology is rationing—or at least more informed use of products and services.
Policymakers need to realize that although physician payments account for 20% of healthcare costs, what we order results in 80% of our annual healthcare bill. Reform will never occur without a systemic reconstruction, aligning incentives of all segments of the healthcare field and delivering evidence-based medical care.
The real question that remains: Is the public willing to accept these changes?
Dr. Joel Shalowitz Northwestern University