Cutting medical care costs. Primum non nocere

Abstract

A serious slowdown in the nation's economy has led to widespread agreement that the rate of escalation of medical care costs must be slowed. In responding to the pressures to cut costs, physicians need to be guided by the basic tenet of medicine: first do no harm. In recent years, this nation has made extraordinary progress in improving health and longevity. A recent study suggestively links reductions in mortality to increased expenditures for health. Thus, physicians should watch closely how the nation reduces medical care expenses. We suggest a series of yardsticks that might track the effects of the nation's cost-cutting efforts on personal health. Keeping a careful eye on where people receive care, how frequently they see a physician, trends in mortality, and the adequacy or timeliness of care could help us keep our sights set on the continuing improvement of the health of Americans.

KIE: Data from a recent Urban Institute study suggestively links reductions in American mortality to the increased health care expenditures of the 1970s. Current economic policy calls for substantial cuts in this area. Physicians are urged to monitor their patients' medical care practices and health and to alert decision makers to any trends that may indicate a cessation or reversal of the continuing improvement in the nation's health and mortality rates.