Universal Considerations for Lowering Health Care Spending

The problem of excessive government spending is pretty universal and a lot of that spending is driven by health care.  A commentary and analysis in Health Affairs explores what tactics might be available to all governments to hold down health spending growth while not limiting access and quality.  (HA Article)   The authors first explore whether and why we should be considered about high health spending, suggesting that the difficulty in committing additional government revenue to health care is the primary motivation for controlling spending.  They then recycle the usual explanations for the growth in spending–aging populations, more use of technology and higher disease burden.   One additional factor is low productivity growth in health care–it is still relatively labor intensive and the productivity of workers has changed little over several decades.  While there is more use of technology, it tends to be very expensive and to add to costs, not help reduce them.  Innovations that could improve labor productivity or otherwise lower unit labor costs would be a factor in reducing growth.  Using patients to do more self-care and using lower paid, but equally skilled professionals, like nurse practitioners or physicians assistants, to deliver more care would both help.  Technology like on-line visits can also be helpful.  And using more telemedicine to rationalize capacity of specialists over a wider geographic area can raise productivity as well.  Regulatory and other barriers will need to be reduced to help achieve these goals, but lowering unit costs seems the most likely way to achieve widespread health spending controls.