Physicians and healthcare consumers all blame insurance companies, drug companies and medical device manufacturers for rising healthcare costs, according to results of a new nationwide survey produced by the Texas Medical Center Health Policy Institute in Houston.
The study also found physicians and consumers in agreement about the most effective ways to reduce healthcare costs: increasing costs for those with poor health habits, and for insurers to offer affordable catastrophic health insurance plans.
Among physicians, 47 percent blamed insurance companies for rising healthcare costs, compared to 28 percent of consumers. Nineteen percent of physicians and 30 percent of consumers blamed drug and device manufacturers for rising costs. But relatively few respondents from either category blamed hospitals or physicians.
Doctors and consumers were also largely in agreement on which reforms were most likely to decrease healthcare costs. The leading solution from both groups was to increase costs for smokers and obese people via higher health insurance costs and taxes on unhealthy food. Forty percent of physicians and 28 percent of consumers believed that is the method most likely to reduce costs. Meanwhile, 23 percent of doctors and 23 percent of consumers said they believe the creation of affordable catastrophic healthcare plans would be the most effective means of reducing costs.
The study offered some potential remedies of its own. One way to reduce costs, it said, could be to shift a greater portion of physicians' compensation to salaries. Today, much of physicians' earnings come from incentive pay based on the volume of care they provide. Meanwhile, it has been estimated that nearly $200 billion per year is spent on overtreatment -- enough to cover all the uninsured. If more doctors were salaried, the volume of procedures would likely decrease, thereby reducing costs, according to the study.
In all, 69 percent of physicians said their preferred way of being paid would be through a high proportion of their compensation being salary -- with a low proportion of their pay based on incentives -- or a straight salary with no incentives.
On the consumer side, the survey found many Americans consider their healthcare costs unaffordable. For example, 49 percent of consumers surveyed say they're forced to cut back on spending in other areas in order to pay for their healthcare.
The majority of the uninsured consumers surveyed, regardless of income, said they consider spending 2 percent of their income on healthcare to be affordable. The Affordable Care Act's individual mandate requires people to obtain health insurance or pay a penalty; those who lack access to "affordable" coverage under that law are exempt from that penalty. But under the ACA, coverage is only considered affordable if it doesn't cost more than 8.2 percent of income.