The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians have an obligation to consider a patient’s quality of life when making treatment decisions and should consider giving patients the options of withholding or withdrawing aggressive treatment if that treatment will not restore the kind of life the patient finds meaningful.
Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
A physician outlines the RAND Health Insurance Experiment and its conclusion that the deductible feature of consumer-directed health plans can reduce health care spending significantly.
Consumer-directed health plans will result in a more responsive and sustainable health care system in which patients will take more responsibility for management of their chronic conditions.