Talking with Patients about Cost Containment.
Source
Institute for the Medical Humanities, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555-1311, USA, habrody@utmb.edu
"Conventional wisdom states that the American public is simply unwilling to talk about the need to constrain the costs of health care. Pundits note that the “R word,” rationing, is one of the proverbial political third rails. Nonetheless, a public health official recently has found audiences willing and even eager to talk about cost containment as an overriding policy priority. He elicits this response after he points out to them that by the year 2033, the projected annual premium for a health insurance plan for a family of four will exceed the projected annual median income for such a family (Michael Fine, MD, personal communication).1
It is notable that this public health official is addressing costs in a public policy forum, and is not trying to introduce discussions of cost into individual encounters between patients and their physicians. Danis et al., in this issue, report on a helpful and thoughtfully designed focus-group study of the latter sort of cost conversation.2 They discovered that generally, patients are very leery of physicians bringing up cost issues, especially when the costs are borne by the insurer and not by the individual patient out of pocket."
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