Can a public health insurance option hold down spending, or will it lead to medicine by committee? : Joseph Hight

Will a public insurance option like health care spending?, health care , In a previous column I asked, so if it is new and improved medical treatments and the expansion of health insurance that increases the total health expenditure, how are we these expenses back under control? Indeed, that, health care , is the $ trillion question.One way that, health care , is proposed to keep the cost of health care through a public insurance option: a government run health insurance plans to compete with private health insurers. It was only intended to cover the costs. The theory is that a government plan for health care costs could reduce its bargaining position with health. Using this bargaining position, will set the prices they pay for certain procedures such as Medicaid and Medicare now. Nobel Prize winning economist Paul Krugman and the New York Times syndicated columnist put, health care , the matter this way, and that is why the government is planning a major component, health care , of the reform: It would help, health care , keep costs low through a combination of a low overhead and negotiating position. This is not an abstract hypothesis, it is a conclusion based on solid experience. Currently Medicare has much lower administrative costs than private insurance, while federal health care programs other than Medicare (which is not allowed to negotiate the price of drugs) pay less for prescription drugs than nonfederal, health care , purchasers. There is every reason to believe that a public option could achieve similar savings.Democrats who trust in a public health insurance option that would compete with private insurance plans. Three conference committees with jurisdiction over health care, health care , reform legislation have offered a package that a new public health option.But will really work include? If the main cause of rising healthcare expenditure is new and better and, health care , more expensive treatments will not only negotiate the trick. In Krugman's own words, written in 2005, he seems to recognize this fact. He said, remember what, health care , happens when a new drug or other therapy becomes, health care , available. Let us assume that the new therapy is more, health care , effective in some cases than existing therapies - that is, it is not just a me-too drug that duplicates what we already have - but the advantage is not overwhelming, health care , . On the other, health care , hand it is more expensive than current treatments. Who decides whether patients receive the new therapy? Finally, we have the fact that there is no magic in the private sector to accept and health - including, health care , the decision about what treatment is provided, health care , - is a public responsibility.We could cite many instances of the appropriate medical treatment are given in individual cases. Whos to say that 55 years old man with a painful hip pain and hip transplant, or to obtain or physiotherapy, massage and anti-inflammatory drug treatment will suffice? Or whether the 50 years old with chest pain while mowing the lawn really need those stints implanted in his veins, instead of, health care , the more traditional, cheaper treatment. Or pain in the balls of my feet after playing tennis, I mean really need repeated trips to the podiatrist for injections as opposed to a few simple soaking of the feet after the play? In the presence of private health insurance, most of these decisions are taken by the, health care , patient and his physician, and in most cases the most expensive, health care , treatment is a chosen.By decisions about treatment, in Krugman's words, a public responsibility we take decision about treatment from the hands of the patient and doctor. In many cases decisions about medical treatment will be decided by a kind of commission. To be honest, I guess the more expensive treatment would be available if a patient is willing and able to pay out of pocket. That could work in the case of the trips to the podiatrist, but the actual prices from hip transplants or stints for most patients.That fear is what most people on a public insurance option. Not that the private insurers from the market completely drive, but it will force private insurers to mimic what happens in a public plan, to only those treatments decided by the committee to appropriate.There are probably, health care , other types of reform our system of health coverage that could help reduce costs, for example, a system whereby health insurance is for catastrophic