Cost Control in Health Care

The letter copied below is a quick response to a mischievous editorial in the weekend Sun. A serious discussion of cost control needs to consider why no country seems to have achieved it (even though costs do vary between jurisdictions). Part of the problem is that buying health care isn't like buying a new car, or at least it ought not to be.

By creating patient resistance to being told that a service is a waste of money and not likely to be helpful, various components of the health industry are able to resist government's attempts to control costs. Pharmaceuticals are one very good example of that problem. The pharmaceutical industry spends over $20,000 per physician in order to influence prescribing patterns. Efforts by the government to counter the industry efforts are measured in the hundreds of dollars per physician. Guess who is winning. In BC we now have a government that appears to be more interested in giving up the fight by shifting costs rather than trying to win it and really control costs.

To: Letters,
Vancouver Sun

Dear Editor:

The Sun’s simplistic editorial on cutting health care (Sept 23) is no different than readers calling for lower pay for editorial writers so the price of the paper will go down.

I imagine that managers at the Sun always look at maximizing results while minimizing costs. Managers, and politicians, in the health care system do the same thing.

Calling for lower wages for everything from accountants to cleaners so as to lower health care costs is no different than the Sun looking to contract out to nonunion journalists so as to lower the cost per article. Management will do exactly that in both cases to the extent that they can, and workers will be worse off for it.

There is one big difference in health care. If we forget that the objective is quality of life, then cost cutting by itself merely connects the admitting room and the morgue.

Sincerely,

David Schreck