Report Calls for Urgent Health Care Action

Key policy changes are needed to prevent the United States from being overwhelmed by rapidly rising health-care costs, according to an article by Peter Orszag, director of the Congressional Budget Office, in the Spring 2008 Issues in Science and Technology.

In “Time to Act on Health Care Costs,” Orszag recommends a combination of consumer cost-sharing and incentives that pay providers more for higher-value care and less for low- or negative-value care. Such a system would offer the best opportunity to cut costs with minimal or no adverse consequences on the quality of care, Orszag writes.

Orszag’s article is one of three in the Spring 2008 Issues focusing on health-care costs and quality.

In “Learning to Deliver Better Care,” Elliott S. Fisher of Dartmouth Medical School argues that rigorous study of the most effective ways to deliver and provide the best care could result in significant cost savings.

In “From Medical Malpractice to Quality Assurance,” Frank Sloan and Lindsey Chepke of Duke University write that a properly designed malpractice insurance system could actually decrease the prevalence of errors and enhance the overall level of care.

Also in the Spring 2008 Issues:

• “Animal Migrations: An Endangered Phenomenon?” — Princeton University ecologist David Wilcove writes that timely international action can sustain this inspiring natural process before it becomes a crisis.
• “A New System for Preventing Bridge Collapses” — In the wake of the August 1, 2007, collapse of the Interstate 35W bridge in Minneapolis, George C. Lee and Ernest Sternberg of the University of Buffalo of the State University of New York, write that not enough is known about the effects that extreme loads can have on bridges. They call for more research and a new structural-health monitoring system on bridges to help avert future disasters.
• “The R&D Future of Intelligence” — Bruce Berkowitz of the Hoover Institution at Stanford University provides a blueprint for how the U.S. intelligence community can best harness the potential of technology to meet the challenges of a changing world. One key: Foster risk-taking.
• “Strengthening Nuclear Safeguards” — Charles Ferguson of the Council on Foreign Relations writes that immediate action is needed to shore up the ability of the International Atomic Energy Agency to detect nuclear weapons programs and safeguard peaceful nuclear programs.
• “Asian Successes vs. Middle Eastern Failures: The Role of Technology Transfer in Economic Development” — Howard Pack of the Wharton School at the University of Pennsylvania says that the differences between the two regions in their openness to trade, investment, and new ideas could not be more striking, nor could the economic consequences be more stark.

Issues in Science and Technology is the award-winning journal of the National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and the University of Texas at Dallas.

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