Controlling health care costs

[Mark Zuckerberg]

Health care costs can be controlled or decreased only by using strategies that decrease the following:

How much people use health care services
How much providers are reimbursed for services
How much the overhead of running a health care business is (overhead excludes the costs of providing health care)

(See also Overview of Health Care Financing.)
Some ways of achieving these goals compromise quality of care while others may improve care. It can be difficult to predict the effects of major changes in the health care system. Often the effects are unknown until after changes are made. Ideally, cost reductions should not compromise quality of care.

Traditionally, insurance companies have limited access to health care as a way to control costs (a strategy that is decreasing because of requirements of the Affordable Care Act).
Unnecessary health care is easier to define than to eliminate and even to recognize.
Whether strategies to improve health can reduce overall health care costs is unknown.
Many strategies used to decrease health care costs also have significant disadvantages.
Reducing overhead costs for insurance companies and health care providers and reforming malpractice laws may help reduce health care costs.

Some strategies have negative effects because they make obtaining needed or preventive care harder. Then disorders may progress, reducing the likelihood that treatment will be effective and leading to disability or even death. Other strategies may improve care.
Evaluating different strategies is difficult, partly because accurately measuring what effect strategies have on the people treated is difficult. Such measurement is expensive and must involve the evaluation of many people, who must be monitored for a long time. As a result, most measures used to assess health care quality reflect how care was delivered rather than how it affected the health of the people treated over the long term. How well care was delivered may not correlate well with how well care helps health over the long term.