Leading policy-makers and scholars explain how market forces, deregulation, and consumer choice can work to improve health care for all Americans.


Lois Quam, The Boston Globe, 3-11-05

Another way to implement the “quality cure” mentioned by Cutler is for health care providers to improve how they treat and manage patients with chronic diseases like diabetes and heart disease, which are very expensive conditions that make up a disproportionately large share of private and public health care expenditures.

Quam believes that the survival of both the Mediciad and Medicare programs may depend on transitioning these enormous federal programs to a payment model that rewards health care providers for treating chronic diseases more effectively.

“Chronically ill patients with five or more medical conditions made up only 20 percent of all Medicare beneficiaries in 2004 but accounted for more than two-thirds of the program’s $302 billion in costs…Too often these patients must make sense of an array of confusing, even conflicting information. This fragmentation of care can lead to poor health outcomes that are unnecessarily costly and draining for patients and physicians alike. We can reduce this burden by organizing our resources more efficiently and effectively. The traditional Medicare and Medicaid fee-for-service systems are structured primarily to provide acute care, not to meet the needs of the chronically ill. These latter patients require comprehensive management of their health, emphasizing coordination of multiple treatments, health maintenance, and prevention of disease.”

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