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Subscribe to RSSIf banking were like health care, it would take days to get money out of an ATM because the records would be lost. If airlines were like health care, pilots would decide on their own which safety checks to make, if any. If shopping were like health care -- well, you get the picture.
It’s a mess, the Institute of Medicine says in a report released on Thursday. The U.S. health care system wasted $750 billion in 2009, about 30 percent of all health spending, on unnecessary services, excessive administrative costs, fraud, and other problems. As many as 75,000 people who died in 2005 would have lived if they got the kind of care provided in the states with the best medical systems, the Institute found.
The report, issued just as candidates for Congress and for president make health care reform a central part of the national debate, doesn’t pull any punches. The panel of experts assembled by the Institute, an independent body that is supposed to provide a non-partisan last word on important issues, leaves no doubt that U.S. health care now is anything but the best in the world.
"The threats to Americans' health and economic security are clear and compelling, and it's time to get all hands on deck," says Mark Smith, president and CEO of the California HealthCare Foundation in Oakland and chairman of the panel.
"Our health care system lags in its ability to adapt, affordably meet patients' needs, and consistently achieve better outcomes."
But there's hope. "We have the know-how and technology to make substantial improvement on costs and quality. Our report offers the vision and road map to create a learning health care system that will provide higher quality and greater value," Smith says.
“What I am seeing around the country is that people are absolutely committed to reform,” says James Conway of the Harvard School of Public Health and the Institute for Healthcare Improvement in Massachusetts, who served on the panel.
“Whether you look at the Republican platform or the Democratic platform, you find in pretty strong language the importance of developing a high quality health care system.”
One of the biggest problems is that health insurers, hospitals and health systems don’t learn from their mistakes, the report says. Half of all health care professionals still neglect to wash their hands properly before seeing patients, even though it’s one of the main causes of infections that kill tens of thousands of patients every year.
An organized system that finds out what went wrong and where, and then provides for the health system to correct those mistakes right away would save money and lives. It’s possible in a computerized world, but it’s not happening on a systematic basis. Hospitals that report every single infection and ruthlessly track down where it came from have found they can cut infection rates to zero, for instance.
Yet just this week the Centers for Disease Control and Prevention reported that a third of Americans have high blood pressure and only half of them have it under control. There are dozens of drugs to treat it, not to mention diet and exercise methods. It took 13 years for one of those drug types, the beta-blockers, to become the standard of care even after they had been clearly demonstrated to work, the report says.
What’s missing, the report says, is coordination. “What I see is people doing a little bit of this and a little bit of that. Everyone has their little initiative. And back at the ranch, the doctor, the individual provider, is drowning in the sea of initiatives,” Conway says. “What is missing is a much more systemic and collective response.”
The report points to two main problems. “One is the increasingly unmanageable complexity of the science of health care. During the past half-century, there has been an explosion of biomedical and clinical knowledge, with even more dazzling clinical capabilities just over the horizon,” the report says. But the current system doesn’t help providers learn this material and it doesn’t give them any incentive to apply it.
“Second is the ever-escalating cost of care, which is widely acknowledged to be wasteful and unsustainable. Unless ways are found to provide more efficient, lower-cost health care, more and more Americans will lose coverage of and access to care.”
Conway praises the Massachusetts health care system, which he says is organized with the patient in mind. The report also says government initiatives, such as the Patient-Centered Outcomes Research Institute (PCORI) and the Center for Medicare & Medicaid Services Innovation Center are good ways to test and apply proven treatments and methods for paying for health care.
“Until we organize the health care system around the people we are privileged to serve, we aren’t going to figure it out,” Conway said. “I don’t think we have done that before -- we haven’t organized it around the person with cancer. That would be a remarkable change.”
Some ways to get there? Let people see what various treatments cost up front. Employers, who cover the health care costs of 55 percent of Americans, can help, too, the report says. They can use their buying power to demand high-quality, high-value health care, and get their employees involved in wellness programs.
So what would happen if shopping were like U.S. health care? "Product prices would not be posted, and the price charged would vary widely within the same store, depending on the source of payment,” the report says.
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- Americans hate health reform but like what it would do
- Countries with the most expensive healthcare
Leave a Comment:
Has anyone ever made their best decisions through the lens of fear and uncertainty? The nurses and doctors I've seen and visited with lately are more concerned about their electronic entries than their patients. I also believe many people have entered the medical field when their hearts aren't in it. Medical professions are people-centered, at least they SHOULD be.
Well, remember the GOP position that people should train for and take whatever job is available, even if they hate the job and aren't suited for it.
Thanks Obama, another one of your great ideas shoved down our throats!
Thanks spud, another inane comment of no value.
Wasn't what Obama wanted. It was what the GOP would let him have. And the whole plan originated with the Independence Institute, a conservative think tank.
Deal with it, spudson.
My husband just completed over 8 years of school to become an M.D. He just started his first "real job" a month ago. Don't blame the docs on this one! They work their butts off and are at the mercy of all the shots called by the bureaucracy-high insurance companies and lousy hospital administrators. Unfortunately, it will only become much, much worse under Obamacare.
See comment #26. Amen, sister!
Yes, Peggy! My husband has grieved since he has started working because he IS patient-centered dr., but has been demanded upon to see twice as many patients! One day, he saw 40 PATIENTS! As a psychiatrist, this is nothing less than impossible, and he let the administation know it! We suspect it will do little good.
Why?
@ acj78: similarly....I had a family doc for about 5 years. He was probably in his early 50's and was the best doctor I remember. Fair, clear and truly patient oriented. He sold his practice and quit 'doctoring'....because of the increased paperwork for the insurance companies. He was beginning to spend more time filling out forms, than with his patients. I don't know what he does now....but whatever it is, I bet he's smiling.
ps: when seat belts were required in cars...each car cost more money; so that was a downer for car buyers. On the other hand, they save millions of lives. So, that's the good side of changing something. (Point being, STOP with the OBAMA bashing, already. It makes people look more stupid than they really are.)
They forgot to mention the fat people who get fatter every day we have walking around who are eating themselves into diabetes, heart disease and cancer. Not to mention the smokers who are killing themselves and others. Stop those problems and healthcare improves significantly for this country.
You forgot to mention the health freaks and athletes we have pulling muscles and breaking bones, eating themselves into malnutrition. Then from age 70 to 100+ the system has to pay for all their care while they deficate all over themselves. They drain money like its water and contribute nothing. Thats what those extra years of not smoking and eating get you.
People who eat carrots die.
Oh, don't dare brag about nurses. They are no longer care givers, but paper shufflers. They allowed themselves to stop caring about patients and instead, sit on their butts at their stations and write reports, shuffle reports, read reports and chat among themselves. Nurses are about as worthless as teachers are now days and that is way worthless.
And eat. All I see are fat nurses overeating when I'm at the hospital!
Become a caregiver and see how much time you have to care for yourself. I've seen all types of health and financial issues happen to people who care for family members and have no time to manage their own needs.
again under Obama's watch, maybee the last 3.5 years of politicing shoulda been spent on attention to problems and actually stopping spending a waste!
Medical in the US has been overpriced and a mess for decades! Obama took a step to get a handle on it. More than the Republicans ever did while in office!
Wow, I sure HOPE they didn't spend to much time coming to this conclusion. My family has been in the Healthcare industry for years, let me tell you straight up. No study needed. The policy makers have no clue and the oversight committees are only going to make matters worse.
If they think its a mess now, wait until the reform bill is in full effect!
Was this a publicly funded study?
One Option, just don't get sick and then you have nothing to worry about.
Happy Trails!!!!!
Thank God i go to the VA. I dont know what the rest of you are going through, and dont want to know!! Va gets a bad rap, but is actually one of the best healthcare facilities in the country. They have their act together. All my records in one database for all my doctors to access from primary care to specialists. Good job VA.
yes it is messed up, obamacare does nothing to help other than force you to be part of it and not have the freedom of choice. if we want to try and fix it then have all doctors who got government loans to be come a doctor spend a specific amount of time in clinics or hospitals for free to repay thier low cost loans. then stop the multi level costs of all the referals. you have to get the doctors free to make decissions about helping a patient without fear of the insurance company and lawsuits. then like they do with milk put in cost limits . charge a specific amount per type of visit/surgery.. also let kids be kids so they can run and play ( schools stop this) so they can learn to be active and about healthy exersize and eating not just the lock them inside away from the playground schools we have these days
Unfortunately, people are too busy blaming the Democrats or the Republicans. Hell, just take a look at some of the comments. Our country is so polarized that it's literally been blinded. Without tort reform, we will just keep going in circles. The article did make me smile though, because just this a.m. I ordered an MRI that deep down I know I didn't need to order. But after what I've seen happen to a few of my colleagues over the years (in terms of court judgments), you better believe that I will ALWAYS have my bases covered now. This has nothing to do with the Democrats or the Republicans. It's an issue that has been needed to be addressed for quite a few years now.
Too bad our House of Representatives wants to resist the systems more successfully used in the rest of the developed world, give healthcare over to private insurance companies, and spend more money on military operations in the Mid-East.
Your so called system IS the reason for the MESS we are in; please don't speak about things you have no idea about. I have to work within Mr. Obama's wonderful health care system daily and it is @!$%#. Why don't you talk to your local doctors, hospitals, nursing homes, home care agencies, etc and see what they think of our lovely new system. The House has nothing to do with the present health care mess by the way; the Republicans tried to stop this fiasco, the Democrats pushed it through...get your facts straight before spewing your rhetoric. Better yet, get a brain and think for yourself for a change.
Everything in US is a MESS
Thank you very much Mr. Obama once again. His Affordable Care Act IS the cause of our current health care "MESS". I am a health care provider and I can tell you, before Obamacare, although not perfect, the system was workable; now, we are just trying to figure out ways to treat our patients amidst the myriad of regulations and massive cuts by insurance companies and the government. Shame on our government for profiting off the elderly and poor of our society and the insurance companies who are raking in BILLIONS in profit with the stamp and approval of the Obama administration; I can only hope God has a special place in hell for these bloodsuckers.
Oh My FREAKING GAWD - Patient PROTECTION and AFFORDABLE CARE ACT (aka Obamacare) is NOT even in effect yet, what is wrong with you??? Pick up a freaking NEWSPAPER and bone up on your reading comprehension. Some people just LOVE to bitch about issues, but I love when they have NO CLUE what they are bitching ABOUT. Get a clue! MAJOR PROVISIONS PHASED IN BY JANUARY 2014, REMAINING PROVISIONS PHASED IN BY 2020. I mean, WHY should we let FACTS get in the way -- that ruins a good old bitch session, now doesn't it? Pathetic!! People shouldn't even be able to vote unless they can pass a BASIC test about what they are voting for and who they are voting for. Just concentrate on your patients, please for the love of God because from what I see, there is so much of THAT lacking in heathcare - PEOPLE WHO CARE ABOUT THEIR PATIENTS.
dang...I'm trying to figure out how to give sourgirl five 'thumbs up's'. Perfect response to GForce's blind and wacky comment.
It seems like for 30% of the population, they don't have to know anything except "if Obama is for it, they need to be against it". They don't have to understand or think about it....just be against it. So frickin tired of this stupidity.
Yes, it is a mess, thank you Obama Care and everything else you have done to this country. You have taken it upon yourself to destroy everything that is good about this country. You are almost done doing it, it must be stopped. People you must vote this man out of office before he finishes his job. You know, that job of destroying out country to the point it can't be re built.
Sorry but that was Bush/Cheney who destroyed this country.
We will continue to have poor health care until we focus on maximizing health outcomes rather than maximizing profits. Good health is not a product.
Tell that to the insurance companies who are making BILLIONS in profit from all our pockets.
There are no simple answers to the healthcare mess we are in. I consider myself to be a pretty smart health care consumer. But how am I suppose to keep costs down when I haven't a clue on prices? This is not a dem or rep issue, it is a patient issue. I go to the store, I see milk is $3 a gallon. I buy the milk. I pay $3 a gallon. I go to the doctor. He doesn't know how much my visit will cost. He wants to do a blood test. He doesn't know how much that costs either. He sends me for a mammogram. No clue what that costs. The insurance company gets the unrevised bill from the doctor. I don't see it. The insurance company has a contract with my doctor to take a big percent off of the bill as a volume discount. They take their discount then calculate how much to pay him based on the contract with my employer. They finally send me an explanation of the bill. I pay a deductible, a coinsurace/copay or, if my out of pocket max has been met, I pay nothing. 30 days or more after I see the doctor, I finally know how much the visit will cost me and the insurance company. That is no way to run a business. Especially one as important and expensive as the healthcare business. Don't even get me started on emergency healthcare...ugh!
That's exactly right! I'm sick of people saying that we should be better consumers and shop around for our health and ask how much things cost. I've tried that and I get the same answer, "we won't know until we submit it to your insurance." That's code for, "we are going to do all sorts of tests and procedures that you probably don't need and we aren't going to tell you how much they will cost you because we want your money!"
The problem is that this is a for profit business and it shouldn't be. When that stops this mess will be fixed!
Like we did not know this already?
It's simple people, the more complex you make a system, the more likelihood there is for:
1) Abuse of said system
2) Administrative (cost) waste/overhead to manage the complex system
3) Exploitation of loopholes in the complex system
Look at our medical system(s), defense department, tax system, etc....
Our so called medical system totally is wrong. If you dont have insurance you can not even see a doctor, so what about the many americans that can not afford the insurance. I had breast cancer and now I can not qualify for insurance for at least 10 years and have been told this by many insurance companies. I was told I could get on high risk insurance through the government but I would have to pay $600.00 per month which is not ok when you cant afford this and have a place to live and food to eat. Now go to the doctor and they say you may have a brain tumor, all I can say if this is true its been nice knowing you, oh and good luck.
pull your head out of the sand it is all George Obama's fault
f-u2012
Are they inferring 0bamacare isn't going to magically fix everything? Gee, how disappointing!
Healthcare workers not washing their hands has as much impact on the health of Americans as does low air pressure in tires for the price of gasoline. It's a factor, but not a major contributor and barely a minor part. Stop with blaming the miniscule and focus on the real reasons of Americans being old, fat and dependent on comfort and convenience, rather than health and personal responsibility. Eat a carrot, chubby.
Ok, so chubby can eat a carrot. What can 'old' do?
Health care in the U.S. is a mess until you go any were else in the world. Government forms and reporting are what really drives costs.
Sooooo bad people from all over the world come here to see how screwed up it is.
What happened to giving your card and the bills were paid? Why not pay your insurence and they pay the bill for normal health care? Need glasses you get glasses. Need teeth get that. NO DEDUCTIONS NO COPAYS!!!!What an idea. NO EXCESIVE PAPERWORK! Everyone knows what shouldn't get covered. A facelift or Boob job would be out.
I can't afford insurence as it is but with people with a high school deploma deciding what gets paid and what's out no wonder it costs so much. Pass a law if you pay for insurence all bills are covered for normal healthcare and the bills would go down.