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Harvard Professor Says Health System Should Pay More for Quality Care

Richard L. Reece, MD
David Cutler, PhD
Edited by: Deborah J. Neveleff

August 2004
Interview

In this interview, David Cutler, PhD, dean of the faculty of Arts and Sciences for Social Sciences at Harvard University, discusses his book, Your Money or Your Life: Strong Medicine for America’s Health Care System, was published this year by Oxford University Press.

Q:What prompted you to write Your Money or Your Life?

A:I have spent a lot of time thinking about what is wrong with our health care system. Survey data indicate that no more than one in five Americans claims to be happy with the medical care system. That seems like an awfully small number of people who are happy with something that is so important in their lives.

Q:One of the principal points in your book involves preventive care. Why is that?

A:We ought to spend more money on appropriate care, and in particular on preventive care, which is a good investment because it will obviate the need for spending even more money on the treatment of acute conditions in the future. But there are two other important points as well.
One is that we need universal coverage of some sort. All individuals must be insured if the health care system is to work efficiently. The other is that we need to measure the quality and value of care, so that we can be sure we are spending health care dollars appropriately. I believe we should implement quality-based bonus payments for physicians. This will encourage physicians to maintain their focus on quality of care and invest in technologies that will help them to provide this care.

Q:What do you think is the best method of achieving universal coverage?

A:We should allow the general public to purchase insurance the way that
government ....

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