Industry’s Voice in Health Policy by Willis B. Goldbeck (auth.), Richard H. Egdahl M.D., Ph.D.,

By Willis B. Goldbeck (auth.), Richard H. Egdahl M.D., Ph.D., Diana Chapman Walsh M.S., Willis B. Goldbeck (eds.)

It is a excitement to introduce this precise quantity of the and wellbeing and fitness Care sequence. it truly is unique for the easiest of purposes: it truly is basically written via representatives. utilizing the bathing­ ton company workforce on overall healthiness 1978 Annual assembly as its place to begin, this quantity captures the sentiments, matters, and event of many that are prime industry's more and more major presence in well-being coverage and economics. whereas a few of the biggest businesses in achieving extra subtle degrees of involvement, the actual fact is still that the majority businesses of all sizes and particularly the smaller companies both won't or can't dedicate the time or assets to develop into energetic contributors. we are hoping this quantity might help exhibit the price of even one person's devote­ ment. even though our organizational concentration is Washington, the WBGH rec­ ognizes that, ultimately, the standard and price of the future health care such a lot americans obtain will be-and should still be-determined on the neighborhood point. To enable this occur with no involvement could characterize an abdication of either accountability and chance. thankfully, we see a progress of involvement, development not only by way of numbers but additionally when it comes to the scope of actions. • spotting that the most important to altering supplier habit is to alter the industrial incentives, emanating from the key payers, em- vi Preface ployers are subjecting their worker gain plans to the main com­ plete scrutiny in lots of years.

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Perhaps we should pay surgeons not to do surgery (a surgeon bank like a soil bank) and hospitals to do away with excess beds. ) Once again, we either make the hard choices with respect to hospital charges and doctors' fees or the government will make them for us. And it isn't likely to get done by jawboning and costly advertising campaigns. I recall hearing Paul Ellwood [of InterStudy] say the medical care business is behaving the way we're paying it to behave, and unless we change the incentives it will go right on doing the same things.

Another principle that does not appear to require NHI for its implementation is 3, which assures freedom of choice of physicians, hospitals, and health delivery systems. This flexibility already exists. Finally, principles 4, 5, and 9 relate to efforts for containing rising health care costs. A number of efforts are already under way; others undoubtedly can be developed and tried. It is hard to see why NHI, which would probably result in pressure to further increase costs, is needed to give impetus to cost control efforts.

Veit envisions will come about through the joint private-government effort described, or through local initiatives by community groups, business, and the medical profession operating outside the HEW program. There is further serious question whether the growth will come in the closed-panel HMOs urged by Mr. Veit or primarily in nonqualified independent practice associations (IP As). There are several reasons to believe that during the 1980s, Initiatives in HMO Development and Health Promotion development of nonqualified IP As is likely to outpace the development of closed-panel plans both in number of plans and in enrollment, at least in the central and southern regions of the country.

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