Daniel Callahan with an interesting essay searching for a practical meaning of the phrase ‘value for money’ in health care, and wondering whether we can use it to control health care costs.
Three different deployments of the concept can be discerned: in contexts where circumscribed comparisons of like with like can be made, where it is a stand-alone principle, and where it is meant to trump short-term cost control in the name of future benefits.
No doubt, there are many other areas of health care spending where the upfront costs are high but the long-term gains are worth it. Unfortunately, we have a cost problem here and now, one that will only worsen if we listen to the siren song of eventual payoffs for more spending now….The sad consequence of our cost escalation is that the upfront costs for later benefits must be cut now, and threats of harm to patients have to be put aside. That is what serious cost control entails if we swear off all evasions and rationalizations. If we fail to do so, our future health care system will have fewer and fewer of any kind of benefits to offer.