The two problems were doubtless connected. Insurance companies responded to the complaints about rapidly rising premiums and especially to the increasingly strident threat of national health insurance by increasingly effective cost-containment policies. The current complaint about HMOs is that accountants, not doctors, are now calling the shots on what to do, and when. Perhaps the pendulum has swung too far from the 1970s, when the only time a doctor thought about the cost of a procedure was when he knew his patient was uninsured. Before we engage in an orgy of recriminations at the insurance companies for being stingy and putting profits over patients, let s remember that part of what motivated their current pennypinching strategy was complaints about overly aggressive and overly expensive medical care.
Medical care is expensive.
The very best medical care is very expensive. If we complain about the costs of medical care, we shouldn t be surprised if insurers decide to take us at our word, and rein in the doctors who are trying to give us all the medical care that we want.