12:42pm

Thu January 13, 2011
Shots - Health News Blog

To Curb Medical Arms Race, Go After The Suppliers

Developed countries are struggling with a stark economic fact: spending on health care is growing faster than their economies.

That's not sustainable, but it's not easy to fix either. Dr. Richard Smith, former editor of BMJ and current blogger over there, takes a look at the problem and reminds everyone that spending more on health care, after a certain point, doesn't do much good. It may even do harm.

Older populations and wealthier people who expect better health may drive some demand for health services. But Smith, pointing to a paper from the health consultants at Volterra, calls out the suppliers of those services as a big part of the problem.

As we reported all the way from Salzburg, Austria, last month, even the British are grappling with supply-related distortions in demand for care despite doctors being paid mostly salaries instead of fees for procedures.

The worst part of the financial rub for wealthy nations trying to tame health spending right now may be that they are stuck with old, costly ways of delivering health care at the same time they're trying new methods that might, in the long run, be more productive and less expensive. For a while, that's a twofer that's adding expense.

Smith notes some folks in less-developed countries who got a look at the report via a listserv popped off about the lectures they've been getting from the well-off:

They reacted passionately, saying 'Why don’t these groups from high income countries stop preaching to us.' Indeed, they suggested a reversal of the usual pattern and proposed that a group from low income countries tell high income countries how they could improve their health systems. Not a bad idea.

But for my money, the best part of Smith's post is the last bit about his own potential conflicts of interest in writing on the subject:

Competing interest: RS is employed by the UnitedHealth Group, which has a UK subsidiary, UHUK, which might benefit from this report if it leads to encouragement for "new players," but the present government is keen on that anyway. RS runs a philanthropic programme for United and does not work for UHUK. He has shares in United, but it's hard to see that what happens in the UK will have much influence on the share price for a long time to come if ever. He’ll probably be dead by then.

Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.