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Cost-shifting could sink healthcare system

Cost-shifting could sink healthcare system

CHICAGO—Soaring expenditures must be contained or they will end up sinking the healthcare system, Allen S. Lichter, MD, CEO of ASCO, said during a featured appearance at the Radiological Society of North America meeting (see photograph below). Among the changes that could help attack the problem is mandatory insurance coverage for all citizens, Dr. Lichter said. He also cast doubt on the ability of one currently popular approach, consumer-driven, high-deductible healthcare plans, to solve the system's problems.

Dr. Lichter, a radiation oncologist by training, made his comments during the RSNA's Annual Oration in Radiation Oncology. The annual oration normally covers a clinical topic, but in a lecture studded with statistics, Dr. Lichter promoted the case for healthcare reform.

He said the growth in the cost of healthcare, now at about 17% of the gross domestic product and expected to hit 20% by the year 2017, is on an unsustainable track. Combined with other trends in medicine—the system is at risk of failure, Dr. Lichter said.

"Either something happens or the healthcare system is threatened. Without cost containment, there will be major shifts of costs to private payers and Medicare beneficiaries," Dr. Lichter said.

Back to 1965?

For Medicare beneficiaries, cost-shifting could be so dramatic that it would "impoverish the over 65 population, and we'll be right back to 1965 when we enacted Medicare so that seniors could have access to great healthcare and not have to face bankruptcy and poverty. We are about to re-enter that cycle, and that cannot be allowed to happen."

A requirement for mandatory insurance would limit cost-shifting in medical care, a pervasive problem that is boosting the costs for those covered by insurance by 9% annually, Dr. Lichter said.


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