Controlling Health Care Costs by Controlling Technology: A Private Contractual Approach

Abstract

The news is depressingly familiar: Health care costs in the United States continue to rise at an alarming rate.As a consequence, private health insurance has become unaffordable to tens of millions of Americans.Federal and state governments could extend coverage to those currently uninsured, 1 but estimates indicate that such coverage would cost at least twenty-four to twenty-seven billion dollars annually. 2 Given present efforts to curtail rather than to expand health care programs, 3 it is highly unlikely that governments will opt to incur these costs.If governments are unwilling either to provide or to mandate insurance coverage, private sector initiatives-perhaps with some governmental involvement-may present the only path to reform.Without entering the debate over whether public or private reform is preferable, this Note proposes a private sector cost-containment initiative that emphasizes controlling the use of medical technologies as a means of controlling health care costs and analyzes the legal implications of such an initiative. 41.Governments could provide health insurance directly to the uninsured.See, e.g., Himmelstein & Woolhandler, A National Health Program for the United States: A Physicians' Proposal, 320 NEW ENG.J. MED.102 (1989) (proposing federal funding for all health care).Alternatively, governments could mandate that