Our Healthcare System is Characterized by Huge Amounts of Waste
Leading to Spiraling Prices that Limit Access to Care
Over the last several posts, I have reviewed the reasons America’s healthcare system falls short of the promise of improved health at lower costs. The amount of waste is almost inconceivable. A review in the Journal of the American Medical Association puts it at nearly a trillion dollars three years ago. That seems crazy, but I believe it is real. Let’s take a look.
Just consider the case of electronic health record machines. There are hundreds of brands and each one is proprietary. The inner workings are secret to protect the financial return from development. They could be like different computers that all use the internet, but they are not. They don’t communicate with each other. As a result, there are all kinds of workarounds to get your health information when you are away from your usual provider. In most European countries there is a single electronic health record that is easily available.
There are over 1000 health insurance companies in the United States. They have different performance standards and quality improvement efforts that create tremendous complexity for provider groups. They have different processes to approve planned treatments. There is little standardization.
The clinical sector is not much better. Consider two of the diagnostic categories that generate the most cost.
Musculoskeletal disorders generate large costs for many employers. The McKenzie physical therapy method uses a series of maneuvers to determine if a particular problem needs urgent orthopedic or neurosurgical intervention. They find that MRIs and CT scans often correlate poorly with the problem that is causing the symptoms. The maneuvers tell them what exercises will help the condition. They teach the patient to manage the problem. They return patients to employment more quickly and durably than usual care. Companies that use this PT method save 30-50% on spending in this category.
By now many of you know the story in cardiovascular and related diseases. Even patients with stable heart artery disease can be treated with optimal medical therapy that costs $30-40 per month even if 6 medications are needed. Stress tests, heart artery catheterizations, and stents are unnecessary in most stable patients. All they do is create additional cost and risk. That alone is responsible for billions in waste annually. Our system is not designed around the needs of patients. It is designed around the needs of device makers, drug makers, insurance companies, insurers, and provider organizations. We can do better and extensive systemic redesign is required.
Yup! For people suffering from metabolic dysfunction and early stage cardiovascular diseases, all the current tests are absolutely useless. Your neighbor Lady Jean is a perfect example of the failed system! Let’s get her retested on our MCG technology platform asap to ensure that her recovery is well on the way!