Incentives, Choices Matter In The Health Care Debate

The article is Reviving the Health-Care Debate. From the WSJ, 2-19-2010, page A15. It is By JEFFREY S. FLIER AND DAVID GOLDHILL. "Dr. Flier is dean of the faculty of Medicine at Harvard. Mr. Goldhill is president and CEO of GSN, a media and technology company." The key exerpts are:

"First, health and health care must not be conflated. Health is shaped by genetics, diet and lifestyle choices, social factors and chance as much as it is shaped by medical care. And all too often, expenditures on medical treatments fail to promote health.

Second, health care should be distinguished from health insurance. Insurance doesn't guarantee appropriate or equitable care."

"Our system favors treatment—especially costly treatment—at the expense of other options."

"...we need to recognize that over the past 50 years we created incentives that have encouraged more expensive—rather than better—care.

The two most important incentives are the tax advantage conferred on employer-based and low-deductible insurance and the administrative structure of Medicare and Medicaid."

"The government's willingness to meet rising costs with ever greater spending and subsidies has also undermined efforts to discipline costs or to seek alternative approaches to organizing care."

"A successful approach would aim to reform misplaced incentives. Giving individuals the same health-care tax deductions businesses get would be a good start."

[we should] "...encourage the purchase of high-deductible insurance coupled with putting money aside in health savings accounts, including a shift to HSAs of some of the funds now paid to insurance premiums."