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Fam Pract Manag. 2008;15(4):12

I found Dr. Bobby Newbell's opinion piece on “Baumol's Disease” [November/December 2007] interesting, but any significant relationship between this “disease” and escalating health care costs is not supported by any data. I agree that “we should avoid the temptation to look for a single, simple explanation” of rising health care costs, but this should not prevent us from recognizing that the major drivers are higher-priced services, rising drug costs, the aging population and technology innovation.

The lack of increased efficiency in primary care cannot be the basis for concluding that “rising health care costs may be with us indefinitely,” as if we are mere victims of the system. Regardless of our degree of productivity, there is much we can do to slow the escalation of health care costs: We can educate ourselves and our patients about the costs of diagnostic and treatment options; we can prescribe generic medications and refuse gifts from pharmaceutical companies; we can provide patients with the care they need – not the care they want; and we can reduce the medical spending occurring during the last six months of life by utilizing a hospice organization and ensuring that all patients have advance directives.

We may never have a direct way to affect Baumol's disease, but unless we become better stewards of our finite health care resources, the ultimate cure for our sick health care system will undoubtedly be imposed on us by politicians, insurance companies, employers and individuals who are unwilling and unable to pay for what they perceive as a health care “product” that is too expensive.


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