WINSTON-SALEM, MC — The U.S. health care system is broken with spiraling costs, according to Steve Feldman, founder of the physician rating Web site DrScore.com and a practicing physician. Whenever debates about health care costs surface, they include claims that rising costs are caused by predatory, money-hungry drug companies over charging, lack of competition for insurers and even malpractice suits.

Not so, says Dr. Feldman, who thinks there is a much simpler explanation, even if the solution itself may not be so easy to bring about.

We have written about Dr. Feldman’s doctor rating site previously on Techjournal South. See: DrScore puts you in the rating seat for background on his physician rating site.

In a new white paper “A Primer on Health Care Reform,” Dr. Feldman debunks common health care reform myths and offers several solutions to spiraling costs.

“U.S. doctors are capable of extraordinary technological feats,” Dr. Feldman says. “However, there are still problems, and, even with health care reform, costs continue to spiral out of control.”

In his white paper, Dr. Feldman debunks common myths surrounding insurers, drug companies and lawyers:

• Myth: For profit insurers don’t have enough competition and contribute to spiraling costs. “There is plenty of competition,” Dr. Feldman says. “Insurers’ for-profit status and high executive salaries are not the underlying cause of high health care costs either — there are many for-profit companies with well-paid executives that deliver great products at a reasonable cost.”

• Myth: Drug companies and the high cost of prescription medications are the problem. “Drug companies are just like other for-profit companies, except that most people don’t pay directly for drug products. Unlike other goods, consumers choose drugs primarily on perceived quality and not on price.”

• Myth: Malpractice lawyers are at the heart of the problem. “While fear of malpractice suits cause doctors headaches, malpractice accounts for only a tiny fraction of health care costs,” Dr. Feldman says.

Dr. Feldman attributes the spiraling cost of health care to the nation’s third-party payer system whereby consumers do not pay for health care services and medications directly.

“When insurers pay the bill, we are insulated from the cost,” he says.

“When buyers and sellers interact directly, most buyers are careful to purchase products and services they value and don’t waste money on things that provide little benefit to them. Solving the problem of ever-increasing costs has to first address the basic principle that someone has to say ‘no’ to high prices and have the incentive to pick the less expensive option.”

Dr. Feldman makes several suggestions to create greater price sensitivity and rein in spiraling costs, including:

• Patients should pay for more of the cost of care themselves. “Drug costs are high because when well-insured patients are given a choice between a $10 drug that may work reasonably well and a $10,000 drug that might work only marginally better, a well-insured patient chooses the $10,000 drug because the insurance company bears the cost,” Dr. Feldman says.

• A health insurance system should cover catastrophic events and require personal responsibility. “With automotive insurance, insurance plans pay for catastrophic events,’ Dr. Feldman says. “We pay for the little stuff, and that helps keep the cost of those products and services low. High deductible health insurance plans provide an affordable solution that puts needed incentives into place.”

• Greater personal responsibility on the part of patients. “If we want patients and doctors to make health care decisions, patients need to take more personal responsibility for the costs,” Dr. Feldman says.  “A physician may suggest performing an MRI, which can cost thousands of dollars, to rule out a very rare risk. If patients had to pay hundreds or thousands of dollars for the test, they might still choose to do it, but would probably think more carefully about whether it is really necessary and would shop around to find the lowest cost provider, the way people do when they buy other consumer goods.”

For more information, or to read the complete white paper “A Primer on Health Care Reform,”  see: www.drscore.com.

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