Cost of Care

The March issue shines a bright light on the high cost of medical care—something all of us talk about, but few discuss with our doctors. In one clinical case, a patient with chronic illness asks his doctor to waive the copay so that he, the patient, can afford to continue seeing that doctor. In another case, a medical student asks her supervisor why he has sent a patient with insurance and symptoms of appendicitis for a CT scan while referring an uninsured patient with similar symptoms to a surgeon without a scan. Two articles urge physicians to be aware of their patients’ cost concerns and to introduce the topic during the clinical encounter so that they can work on possible solutions together. Policy articles look at the effect of medical debt on access to care and overall health and at the possible consequences of the new pay-for-performance reimbursement model. Wickline v State of California explains one court’s unequivocal opinion that physicians are responsible for seeing to it that patients receive needed care, despite a third-party payor’s decision not to cover that care.  

Volume 8, Number 3: 125-190 Full Issue PDF