Controlling health costs

...Now consider this alternative...

...During a routine phys- and that it may be more effective to probe this relationship and ical, we discussed whether or not I should receive to change our behavior accordingly than it would be to simply boosters for measles and tetanus...

...Why does treatment X cost so much...

...Then he to inflate the high cost of health care...

...Yet this family practice not only gives great care, ciferously rejected the Rainbow Curriculum, were Catholic, it gives affordable care...

...It cannot be produced simply by legislation or insur- In such a new market, consumers (the patients) would have a ance reform...

...I don't don't feel comfortable spending money like that...

...Despite arguments that medical students and this in turn is a major factor in runaway health costs...

...OF SEVERAL MINDS Abigail McCarthy force capable of drawing on shared values" in a world where temporal politics have failed...

...It's a medical practice in a black, working-class, West often noted-as was her Mass attendance at Saint Patrick's- Philadelphia neighborhood bordering on the mostly white but not that of any other board member, even the other two University City neighborhood surrounding the University of who ultimately voted against Fernandez...

...did so in the context of Pope John Paul's and justice...

...He and his staff of physicians and physician assistants including some Catholics, some Orthodox Jews, some African- strive to give thorough care...

...If you can't pay the fees, talk to us...

...A patient who spends $100 for a minimal, routine office visit and leaves without all his or her questions being answered has experienced a failure in medical care...

...Suppose insurance companies JEREMIAH P. REILLY required a 10 percent copayment with a $5 minimum and a $50 Jeremiah P. Reilly, a writer and illustrator, holds a mascap...

...It ought to: you are paying for it indirectly...

...My CONTROLLING HEALTH COSTS concern is that the high cost of primary care drives away conMAKE IT PERSONAL sumers: mothers do without prenatal care...

...How does $20 for a quick visit proceeding from there...

...We discussed the med- overhaul the insurance system...

...Today's all sides...

...icant step in the transformation of health care in America...

...Assuredly, the healthand lesbians in the first-grade curriculum, and-most impor- care situation is complex and includes issues such as termitant-the responsibilities of fair and full news coverage, it strikes nal care, AIDS, tuberculosis, multiple organ transplants, drug me that it's the Times that should worry about mindlessness abuse, infinite expectations, and so on...

...Routine ofstarting with an inability to treat religious objections to ho- fice visits are so reasonably priced that I gladly pay for them mosexuality or homosexual conduct as other than bigotry, and to get high-quality care...

...Please take your time," one said...

...Call the office if you are going to including homosexuality...

...this treatment well spent...

...erarchy...

...ter's degree in applied economics from the John F. Kennedy Already there's an incentive to shop around...

...Please call our office first...

...And as sure suggestion in calling for health-care providers to watch their as day follows night, some providers would compete on the costs...

...However, like most matters of behavior, cost-con- basis of cost...

...The Times rarely fails to note that Catholic lay health care is a partnership: Don't abuse the opportunity to people have views of their own on a range of sexual issues reach physicians by phone...

...And patients might become more Nor do patients sufficiently internalize the cost of their care...

...In other words, if costs pinched a little, patients might health care in the coming decade, it is reasonable to suggest start asking questions and considering alternatives...

...His staff returns phone calls...

...The current crisis in dothe hierarchy-and agree with the Times...

...True, but sometimes we tend to make our may keep insurance rates down but it does not provide en- problems too complex...

...United States who are uninsured or the number of dollars by In the case of condom distribution in the high schools, gay which health-care costs rise annually...

...to me that my doctor believes deeply in providing good, afCommonweal 12 March 1993: 5 fordable health care...

...Do you have any direct or beneficial payments would be capped...

...Quality, reliability, convenience, proximity, and sciousness in medical care can be taught by example...

...Do I really need treatment, a minimum percentage of the total cost, and that such this treatment anyway...

...Hospitals, medi- School of Government at Harvard University...

...If costs are that it would benefit physicians and patients alike if we would diffuse, one's recourse is to complain...

...of whom had some objections to the curriculum, were never Significantly, the office brochure stresses that providing good mentioned...

...world riven by religious conflict...

...Looming behind these and puppetry...

...Get Irene hnpel l izzeri, one of the school board members, was des- this: the receptionist phones you when the staff are running beignated by a Times news story "a voice for the Catholic hi- hind so you don't come in and have to wait...

...Currently, attending physicians and chief residents, could ignite a spiri- the cost-factor is too often absent in medical considerations, tual transformation...

...MARGARET O' BRIEN STEINFELS megaproblems, however, are the increasing cost and declining accessibility of primary care, the care most families are MEMO TO HRC concerned about...

...A $50 treatment would cost $5, a $125 treatment, $12.50...

...A hand- urgency, all would be factors in purchasing medical services, ful of instructors in each medical school, and a handful of just as they are now in other purchasing decisions...

...children are not vaccinated...

...give all patients the incentive to seek less expensive care, and I am well aware that this brief proposal may be attacked from it would bring providers into the free market...

...by virtue of the copayment...

...Opponents of the Rainbow Curriculum, sound...

...not Catholic...

...And we patients can ask our providers I think that a minor change in health insurance might effec- questions, thereby raising their consciousness: How much will tively help patients to internalize a sense of the costs of medi- this cost me...

...I submit that the problem of poor primary care may lie in the structural relationship between patients and health-care providers, have a great family physician...

...added his financial concerns...

...For it is the current relationship ical reasons for and against getting the boosters, con- between patients and health-care providers that goes a long way cluding that the boosters were not necessary...

...The story com- prising conclusion that the pope "seeks to to ethnicity is tearing the post-cold war pressed into one column an admirably redefine religious diversity as a positive world apart...

...You can expand this list easily and endlessly...

...But his commitment is a matter of the cal labs, x-ray facilities, all would face a transformed market...

...Presumably they are Pennsylvania...

...Thus, I acknowledge that I am making a radical self-interest in finding the least expensive provider...

...American protestants, and some Hispanic evangelicals, were "In this practice we believe in spending time with patients and dismissed as members or tools of the Religious Right...

...babies suffer malnutrition...

...A flat charge sis is not so simple...

...The not to think that they would have done what New Yorkers usu- office brochure flatly encourages patients to call the office, in ally do when such conflicts erupt-compromise and urge the all but traumatic emergencies, before going to a hospital emerman they imported from Miami to fix the schools to do so as gency room...

...It is clear feel comfortable spending money like that...

...you money by addressing your concerns on the phone...

...When we don't, we mestic health care, as it is often styled, is treated as a probare mindless puppets of Cardinal O'Connor and Brooklyn's lem of numbers, whether it be the number of people in the Bishop Daily...

...We can often save well...

...Recognizing that apples are apples and couragement to the patient to seek the least expensive treat- not pears, and that there are going to be a variety of changes in ment...

...I propose that there be a modest copayment for all cheaper provider...

...This modest reform would at once interest in the treatment you are ordering...

...I have to be careful," he said, Medical providers, who are mostly physicians, do not suf"in how I recommend treatment...

...It was also duly and regularly recorded that mem- In my experience few physicians keep the cost of their treatbers of District 24, the local school board in Queens that vo- ment in mind...

...I hear the paper tigers growling: "The health-care critypical copayment, if any, is a flat, nominal charge...

...This evidently is the "new crusade" of the headline...

...Apparently, we show ourselves ca- be late...

...Each provider ture which encourages a self-centered, cost-blind attitude would make the costs of treatment more visible (and palpable) among physicians...

...leave medical school shackled with debt, I think the real ob- By restructuring insurance, providers might be forced to bestacle is the I-work-damn-hard-and-deserve-a-big-salary cul- come more accountable to the buying public...

...cognizant of their responsibility, or at least coresponsibility with The costs are hidden, to a large extent, by medical insurance their physicians, for keeping costs down...

...In one Not only did the Times "uninform" us, its news coverage daytime but after-office-hours emergency, I got an appointment displayed an animus that can only be called anti-Catholic, on fifteen minutes' notice: "Come in right now...

...We can keep our pable of thinking for ourselves only when we disagree with fees low only if you work with us...

...Never mind that Cowell RELIGIOUS WARS...

...Raising course is to relieve the pinching...

...Crusade" and topped a story The story came to the somewhat sur- The common view is that religion tied by reporter Alan Cowell...

...But mutual responitself...

...If the patient pays a flat charge, the consciousness of physicians and patients, coupled with a whether the treatment costs $50 or $125, he or she has not in- small structural change in health insurance, might be a signifternalized the cost of the treatment...

...How so...

...cepted a $700 payment for a $1,000 MRI bill doesn't hit you Physicians must be trained to routinely ask: Is the money for in the gut...

...Ninfa Segarra's religious affiliation (Catholic) was It's not...

...Is there a generic substitute...

...uses the caveat that there is much historiAND RELIGIOUS PEACE cal evidence to the contrary and that in a later story (February 24) he emphasized only the pope's stiff denunciation of the Muslim oppression of Christians in the Sudan...

...if costs pinch, one's re- jointly take responsibility for keeping costs in check...

...If I casually recommend to a ficiently internalize the cost of health care...

...spirit...

...The owners in the thousand of my patients that they receive booster vaccinations, medical practice I described above choose to internalize it: "I at $25 or $30 a pop, I've just spent $25,000 or $30,000...

...He The headline in the New York succinct review of the shift in the role of has sounded the hopeful note that the pope Times on February 12 drew religion since the end of the cold war and has a vision of religions united for peace little notice as far as I can tell...

...Indeed in terms of world 6: 12 March 1993 Commonweal...

...And holds that vision in a It read "Pope's Trip: New recent trip to Africa...

...answering their questions...

...Sound like Oz...

...Seeing an insurance confirmation that a provider has ac- sibility for holding down health-care costs only begins here...

...Is there a cal care...

...It does so precisely because its ownalthough the religious affiliations of other local boards, many ers think about costs...