Cost Control, Back in the News

In the wake of Atul Gawande’s much-discussed article in the June 1 New Yorker—in which he argued that a key factor driving up medical costs was a professional culture that tolerates doctors who order too many expensive but unnecessary procedures—the hot health care reform topic was, briefly, how to control expenses. But in the last few weeks, much coverage of the reform debate has returned to more familiar topics: how to expand access to care, and how to foot the bill.

After CBO Director Doug Elmendorf testified in Congress yesterday that the reform proposals his office has seen to date won’t “bend the curve,” we may soon be reading more about cost control measures. Politico’s David Rogers was ahead of the game with a report Wednesday night that the White House would push a plan transferring authority to set Medicare payment rates from Congress to the executive branch. In a pair of posts at The Treatment, The New Republic’s health care blog, Jon Cohn discusses the White House’s reasoning for why this will help slow the growth in spending. Amidst all the other health care-related activity this week, this topic hasn’t gotten much play in the major papers yet, but it may show up in more stories soon.

Relatedly, Natasha Singer has a long, interesting story on the front page of The New York Times today pushing back against the idea that the government should be promoting widespread cancer screenings for people who aren’t known to be at risk. The article has a lot of detail on the potential negative health consequences of unnecessary screenings, but it also points to their economic cost. One doctor estimates that follow-up surgery prompted by false alarms in mammograms costs between $14 billion and $70 billion over a decade.

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Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.