2008 State of the State of Health Care Conference: Susan Dentzer

Susan Dentzer, editor in chief of Health Affairs, reviewed the literature on the causes of rising costs and suggested solutions. According to Dentzer, why are costs rising?

  • advances in medical technology
  • poor health status, especially obesity
  • poor productivity
  • no competition on prices
  • Fee for service penalizes those who re-engineer their practice
  • NOT: aging population, or malpractice costs

Solutions? Dentzer explored two approaches – from the Commonwealth Fund, and the Center for Studying Health System Change. These include:

  • expanding health IT
  • employment comparative effective studies
  • patients sharing in decision making
  • disease prevention
  • realigning incentives
  • correcting price signals, such as re-setting Medicare Advantage rates, and permitting negotiation of Medicare prescription drug prices
  • payment reform – fee for service is toxic to health care

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