Medicine of the Future in America

The Paradox of High-Tech Health Care: Thoracic Surgeons

To maintain our high standard of high-tech health care we must find some way to reduce the cost without reducing the quality. Your President, with the Government Liaison Committee of ACCP was privileged to meet with some of the advisors to the Congress on the DRG system (PROPAC), and it was evident that in the year since this system was instituted, some hospitals, particularly those specializing in high-tech health care, have done well because of the “unbundling” of high-tech health services and the implementation of increasingly new and sophisticated technology, which the government has as yet seen fit to reimburse reasonably well. It may, however, soon change so that some of the costs of these services may not be fully reimbursed under new DRG levels. itat on

We must work within the system while seeking to change it. For example, the Society of Thoracic Surgeons is working with HCFA on cost logistics of coronary artery bypass, and many other colleges and professional organizations, including the ACCP are working with government agencies to help define the DRGs more explicitly.
Obviously, the cost of high-tech health care is an extraordinarily complex and politically charged situation, and high-tech health care physicians and surgeons are those most intensely illuminated. If we wish to preserve the quality of high-tech health care, we must actively and aggressively take charge of what is left of our own destiny This means that, when asked, we must serve on committees in Washington and state capitals that are helping to contain the economics of health care by cooperation with the profession. Further, we need continuing accurate efficacy data on medical devices. We need organized committees of the ACCP and other societies on standards of care and indications of utilization of devices, and in some very experimental high-tech health care areas, such as the artificial heart, we need controlled regional utilization until efficacy is proved and costs reduced. We must also push manufacturers of medical devices and drugs to become more cost conscious than ever, and we must teach our students, residents, and colleagues to be cost conscious and responsible for the public every practice day.

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