|RICARDO ALONSO-ZALDIVAR, Associated Press|
"Health care in America presents a fundamental paradox," said the report from an 18-member panel of prominent experts, including doctors, business people, and public officials. "The past 50 years have seen an explosion in biomedical knowledge, dramatic innovation in therapies and surgical procedures, and management of conditions that previously were fatal ...
"Yet, American health care is falling short on basic dimensions of quality, outcomes, costs and equity," the report concluded.
If banking worked like health care, ATM transactions would take days, the report said. If home building were like health care, carpenters, electricians and plumbers would work from different blueprints and hardly talk to each other. If shopping were like health care, prices would not be posted and could vary widely within the same store, depending on who was paying.
If airline travel were like health care, individual pilots would be free to design their own preflight safety checks _ or not perform one at all.
How much is
Getting health care costs better controlled is one of the keys to reducing the deficit, the biggest domestic challenge facing the next president. The report did not lay out a policy prescription for
Both Obama and Romney agree there has to be a limit to
But panel members urged a frank discussion with the public about the value Americans are getting for their health care dollars. As a model, they cited "Choosing Wisely," a campaign launched earlier this year by nine medical societies to challenge the widespread perception that more care is better.
"Rationing to me is when we are denying medical care that is helpful to patients, on the basis of costs," said cardiologist Dr.
More than 18 months in the making, the report identified six major areas of waste: unnecessary services (
Examples of wasteful care include most repeat colonoscopies within 10 years of a first such test, early imaging for most back pain, and brain scans for patients who fainted but didn't have seizures.
The report makes ten recommendations, including payment reforms to reward quality results instead of reimbursing for each procedure, improving coordination among different kinds of service providers, leveraging technology to reinforce sound clinical decisions and educating patients to become more savvy consumers.
The report's main message for government is to accelerate payment reforms, said panel chair Dr.
"It's a huge hill to climb, and we're not going to get out of this overnight," said Smith. "The good news is that the very common notion that quality will suffer if less money is spent is simply not true. That should reassure people that the conversation about controlling costs is not necessarily about reducing quality."
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