(Community Matters) Arnold S. Relman, M.D. is Professor Emeritus of Medicine and of Social Medicine at Harvard Medical School, and is former Editor-in-Chief of the New England Journal of Medicine.
The main drivers of medical inflation are fee-for-service payment of physicians, and all the other incentives in the current medical care system for increasing providers’ income. We will not control costs without major changes in the way medical care is organized, delivered and paid for.
Without such changes our health care system is not viable for much longer, but hardly anything of substance was said about that. In fact, the president emphasized his determination to keep the structure of the present system largely intact by steering a middle course between the major reforms advocated by liberals and the free market approach favored by conservatives. He even seems willing to abandon a strong public insurance option in order to get something done now.
This political strategy may work in the short term, but certainly not for long. I’m afraid history will not heed Mr. Obama’s intention to be the last president who will have to fight for health reform. Until a political consensus for major change appears, the struggle will continue.
Community Matters 