The root of the problem

The NEJM gives the most accurate assessment on why health-care costs are increasing:

Over the long term, new medical technology has been the dominant driver of increases in health care costs and insurance premiums. “New technology” includes not only new diagnostic procedures and treatments that are more costly than older ones, but also some that cost less per unit but are more effective or cause less discomfort to patients “” qualities that stimulate much higher rates of use. Additional applications of established technologies (for example, magnetic resonance imaging) may be even more important to cost increases than technologies that are being applied to medical care for the first time. Some new technologies “” many vaccines, for example “” do result in lower spending, but research has shown that, on balance, changing technology in medicine results in increased spending and accounts for one half to two thirds of the increase in health care spending in excess of general inflation.

One area of cost-containment would be a judicious use of these new technologies – but sadly, not emphasized:

Greater adherence to the practice of evidence-based medicine, additional research on the effectiveness of medical treatments, and greater assessment of technology before it is used outside research settings may all lead to gains in efficiency, but neither candidate devotes much attention to these issues.

Simply put, cost-containment is not a priority in this election:

That neither Bush nor Kerry is aggressive about containing costs is not surprising. Presidential campaigns are focused on promising to do things for voters “” not on taking things away. We can only hope that whoever is elected president will move beyond campaign-trail rhetoric and provide the leadership needed for a candid national discussion about health care costs.