The Unsustainable Cost of Health Care

The Unsustainable Cost of Health Care
The Unsustainable Cost of Health Care
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This report provides a detailed analysis of the underlying causes of the uncontrolled rising costs of health care and their impact on American society, as a whole, and individual segments of the population.  In addition, this publication provides recommendations for controlling costs. The report was prepared by the Social Security Advisory Board (an independent bipartisan Board created in 1994 by Congress and appointed by the President and Congress to advise the President,  Congress, and the Commissioner of Social Security on matters related to the Social Security and Supplemental Security Income programs).  This report was commissioned due to the dire economic consequences of not addressing the rising cost of health care:

"This Board believes it is necessary to offer our own perspectives, not because we are particular experts in health care policy, but because we believe that the rising cost of health care represents perhaps the most significant threat to the long-term economic security of workers and retirees" (from the Introduction).


Table of Contents

Table of Contents:

The Cost Of Health Care Threatens Retirement Security 1

Trends in Health Care Spending  1
Are We Spending Too Much?  4
The Extent of Geographic Variation in Health Care Spending  4
Explaining the Sources of Geographic Variation in Health Care Spending  5
The Impact of Rising Health Care Costs on Retirees, Workers, Employers and Governments  7

Impact on Retirees  7
The Impact on Workers  7
The Impact on Employers  9
The Impact on Government Finances  9

Why Health Care Costs Are High And Growing Rapidly  11

Technology 11
Insurance  11
Aging and Demographics  12
Health Status of the Population  12
Income  13
Administrative Costs  13
Changes in Health Care Price  13
Medical Malpractice Liability  13

What Can Be Done About Health Care Costs?  15

Improving the Efficiency of the Health Care Delivery System  15

Process Improvement  15
Organized Systems of Care  17
Coordination of Care  18
Diagnostic and Treatment Tools  19
Informed Patient Choice and Shared Decision Making  21
Emphasis on Wellness  21
Health Information Technology  21

Aligning Financial Incentives to Reward More Effective and Efficient Care  22

The Current System: Volume Rather Than Value  22
Managed Competition  23
Pay for Outcomes  23
Incentives for Consumers of Health Care  23
Consumer-directed Health Care  24
Incentives for Providers of Health Care  24
Dealing with Unwarranted Variations  25

Conclusion  27

Appendices  29

Appendix A: Long-term Care 31
Appendix B: International Comparisons  33
Appendix C: Organizations and People Consulted  37
Establishment Of The Social Security Advisory Board  39


Policymakers, lawyers, health insurance companies, economists, health care providers and institutions, and consumers who pay for (or are looking for) health care would find this publication useful.

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Social Security Advisory Board
Key Phrases:
  • Health Care
  • Medical Care
  • Social Security
  • Health Insurance
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