Overheard

Sticker Shock
Summer 2014

Here in the United States, we pay $2.7 trillion each year for health care, and that number is increasing. Though the Affordable Care Act has made health insurance possible for millions of Americans, whether it will help control costs is in doubt. We talked about the issue with this year’s School of Medicine commencement speaker, Elisabeth Rosenthal, an MD. In her New York Times series “Paying Till It Hurts,” she examines how incentives built into our health care system drive up the price of drugs, tests, and procedures.

Why are health care cost discussions taboo in this country?

We have this weird notion that if you talk about value or cost-effectiveness in health care, you’re on that slippery slope to talking about death panels and [saying], “It’s not worth saving someone.” It’s a big misconception that talking about costs means your life is not worth it. It means, “Let’s think about how to spend our health care dollars wisely.”

Also, a lot of people are making a lot of money in our health care system right now, and they don’t really want to talk about high prices. Their first concern is to figure out how they can keep their piece of that $2.7 trillion health care pie.

How can patients keep their own health care expenses under control?

We’re in a really difficult moment for individuals. All our plans are asking people to pay far more of their medical expenses. That does make people more cost conscious, but we’re not giving them the tools or the information they need. One thing I would push for in the near future is to have more price transparency.

So would health care price transparency be an effective national reform?

I would put that pretty high up. There are a lot of things we can do. A lot of people say we should just have price regulation or single-payer, which would also work. It’s not like it’s a great mystery what we could do—the mystery is what we’re willing to do.

The question in the end is going to be, “Will all of that private market stuff be sufficient?” Or are we going to need to do what almost every other country does, which is to have some form of national price setting or price regulations?