David Himmelstein is an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program. The author of numerous studies and books, he is a leader in the movement for universal health care.
AARP: H.R. 676 does not address the problem of increasing healthcare costs. Rather, it allows costs to continue to grow. By 2016, projections show total health spending almost doubling to $4.1 trillion and consuming one-fifth of the nation’s gross domestic product. Possible efforts to control costs include: “comparative effectiveness” research, a generic pathway for biologic drugs, and increased attention to prevention and care coordination, none of which are included in H.R. 676.
Dr. David Himmelstein: There is absolutely no evidence that the AARP’s favored cost control mechanisms work. The CBO has refused to credit significant savings from care coordination, or prevention. The recently published Medicare Demonstration project of care coordination found no savings. A New England Journal of Medicine review of prevention found that most prevention efforts result in increased costs, not decreased.
Comparative effectiveness research is worthwhile – as are prevention and care coordination – if done right – but is unlikely to significantly cut costs.