A 12-step approach to taming healthcare costs

Ever think of spiraling healthcare spending as an addiction?

Nancy Turnbull of the Harvard School of Public Health has.

She lists the state's symptoms on WBUR's Commonhealth: denial that we have a problem, rationalization that higher quality justifies higher costs, blaming others (providers, insurers, patients), the need to use more to get the same effect, and an inability to meet other responsibilities.

Based on 12-step approaches to addiction, she offers six proposals to recover spending sobriety, including advice to "embrace a greater power" in the form of an engaged government.

"Costs have been a 'crisis' for as long as I have worked in health care. We have brief periods of sobriety when costs moderate, but then we relapse," she writes. "This behavior is typical in families with addiction problems. We need to confront the problem and talk openly about how it affects us, and the role that each of us plays in contributing to the problem, be it as deniers (providers), enablers (insurers and employers), rescuers (consumers), or martyrs (government)."