Where Health Care Law Falls Short: Cost Reduction

Over the last few years Harvard Business School has targeted the health care industry for much research, with an eye towards figuring out ways the business of health can be more efficiently constructed to drive down costs and improve outcomes. Many faculty are engaged in this pursuit, and it's fair to say not all see eye-to-eye on the issues.

So it was of interest when a number of faculty, at the School's request, offered perspectives on this week's health bill and what should happen next. Each agreed it was far from perfect legislation, but a common thread ran through all. Universal coverage is an admirable accomplishment of the plan, but where are solutions to control costs?

Here's a sample.

• Bill George "The bill addresses only one of the four essential elements of health care. Beyond insuring the uninsured,cost, quality, and lifestyles are not addressed. Unless we focus on all four, we will continue to have a dysfunctional system with unaffordable costs."
• Richard Bohmer "We need to make a distinction between debating how it will be paid for and what the 'it' is that is paid for." He argues we need more change around how health care can be delivered, citing experiments with disease management programs, substituting nurse practitioners for physicians in certain circumstances, in-store clinics to treat simple diseases, and "experiments with IT to enable precise electronic communication between patients and doctors so that real medical discussions can be had at a distance."
• Regina Herzlinger "The costs of this legislation, more than $900 billion, will put another nail in the coffin of the U.S. economy and open the door to a government-controlled health care system that gravely injures the sick and the entrepreneurs who could help them, along the way. The problem? The absence of a way to control the costs that already cripple U.S. global competitiveness."
• Robert Huckman "The good news is that the bill tackles many important issues related to insurance coverage. The more sobering news is that addressing coverage issues shines a bright light on the more fundamental reform that still needs to occur -- improving the process by which medical care is actually delivered to patients."