Before any cuts in health care services should be considered, I say first cut out the major crooks. One may say this is an often-used gambit; that people who seek to avoid tough choices claim that you can pay for what must be done by curbing fraud and abuse. However, in this case, there is strong evidence that scores upon scores of billions could be saved in this way. According to estimates from the federal government and the National Health Care Anti-Fraud Association, more than $100 billion are lost each year to fraud, abuse and waste in the health care system.
Another well known but still true source of savings concerns the costs of administration. Physicians for a National Health Program find that more than 30% of U.S. health spending - $294 billion - goes to paper work and administration, compared to only around 17 percent in Canada. This large sum is due to a crazy system that tries to check every transaction, every medication, x-ray, and procedure provided to most patients, instead of paying physicians and hospitals a flat fee, known as capitation.
Finally, while the envisioned commission of experts finds out which procedures and medications are useless, we should stop paying doctors and stop reimbursing patients for those items we already know - beyond a reasonable doubt - have no discernible benefit.
Even if these measures are taken, we still may be short. However, it is morally repugnant to claim that we cannot afford to provide beneficial medications and services to patients while so much money is being lost due to abuse, poor administration, and interventions that have no proven benefit.
Amitai Etzioni is a professor of sociology at The George Washington University and the author of The New Golden Rule (Basic Books, 1998). For more, please visit http://www.gwu.edu/... Etzioni can be contacted at icps@gwu.edu.