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Question:
It's very easy to criticize the health care industry in the US. But everybody wants Cadillac care at Chevy prices. Who will pay?
- H. D. Matthias, M.D.

Hedrick Smith:

You raise a question about why more people don't accept the cost for health care and expect to get Cadillac care at Chevy prices. The question of who will pay is a matter for politics to decide, and that will develop over the years.

As you know, historically it has been employers who have paid for health care, but gradually the percentage of people covered by employers is going down. Then of course, the government stepped in with the Medicare and Medicaid programs. They support a good deal of the cost of health care for many people in this country. But there too, there are some limitations and there are some co-payment requirements.

In the particular case of the elderly woman with breast cancer who's daughter was upset because she couldn't go to the particular cancer treatment center that she wanted, the family was able to find an HMO which did provide that coverage. It was an HMO that was non-profit and was able to and felt it had to provide the best quality care. It was a for-profit HMO that turned down the request to go to the most desirable cancer center.

Thank you for your interest.

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