This is a great overview of the facts and clearly
demonstrates the urgent need for evidence-based medicine.  No matter what
form health care reform takes in the future, the issue of cost has to be
addressed.  However, I believe that a significant key to solving the
puzzle of spiraling cost is an active and educated consumer of health
care. 

To begin the process of developing such a consumer, there
must be financial “skin in the game.”  How often does a consumer of
non-health care goods purchase a car, home or a computer without asking the
price of the item?   All would demand a Rolls Royce if someone else
paid the vast majority of the bill.  Admittedly, when it comes to health
care, the information needed for efficient purchasing is not sufficiently available
and is more complex than that necessary for purchasing simple consumer
goods.  However, this is not an excuse for lack of consumer participation
and decision-making in the economic process of health care.

Have you noticed that most discussions of health care
reform are supply-side and payer driven?   This is yet another
indication of the passive role that consumers take in our health care
system……..like children with parents who know better who make the major
decisions for us.

-Barbara E. Rodin, Ph.D