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limiting care that will bring the cost down. Data shows we have regulated without success, compelling doctors and hospitals to fill out forms for expensive medicines, scooters, and diabetic shoes, demanding they follow protocols for costly MRIs, X Rays, and tests. And while such regulations have accelerated in this country, physicians and patients have been angered, care has slowed down, and costs have continued to skyrocket.
• Someone has to make the tough choices, when appropriate, not to waste money on expensive, heavily marketed, but minimally helpful advancing technology, testing, and medicines. Those tough choices cannot be made by physicians who can be sued at the drop of a hat for any bad result, cannot be made by government regulators who do not have an understanding of the intricacies of the patient's true needs, and cannot be made by insurance payers responsible for saving money for the company. Those tough choices have to be shared and directed by patients with education, consultation and the direction of their personal physician.
• But there are problems. How do we deal fairly with all when some people are rich, some are poor, and most are in-between? How do we keep people from making bad uninformed choices? How do we protect the failing elderly from an uncaring family?
• Could there be a way to adjust the shared cost according to the patient's ability to pay and to the scientifically proven value of the test or intervention? Patients would pay, according to income, more for minimally helpful interventions, and less for high value medicine.
• Patients need to have the incentive to search for and find value. We should expect more from Washington than more regulation.
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