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Three Big Ideas for Saving Our Ailing Healthcare System<
by: Theresa Defino
The American healthcare system is broken. Can there be even the slightest doubt? Consider just some of the evidence:
We asked some of the biggest thinkers in healthcare to share their solutions for addressing escalating costs, the malpractice crisis, and the healthcare needs of an aging population. Some of their ideas may seem radical, but our healthcare system is gravely ill. It needs more than bed rest and fluids. Cutting the Fat In 1980, the nation spent an estimated $246 billion for healthcare. By 2003, annual U.S. healthcare spending reached nearly $1.7 trillion — a nearly seven-fold increase in 23 years. What’s feeding this growth? And what can be done to slow down the rate of increase? Nowadays, the trendy explanation is that Americans are “disconnected” from the cost of their medical care, and thus they make costly, and unwise decisions. This supposition has been the driving force behind so-called consumer-driven healthcare. Congress created health savings accounts (HSA) that would conceivably give patients more control over the dollars they spend, while health plans have been raising drug and specialists’ copayments to presumably prompt more generic use and greater use of primary-care physicians. Economists preach that too much money is spent on care that is of little or no benefit. But could this explanation off the mark? Yes, says Ken Thorpe, PhD, chairman of health policy and management at the Rollins School of Public Health at Emory University in Atlanta. American healthcare would be cheaper if Americans themselves were healthier, he argues. Thorpe and his colleagues contend that 60 percent of the rise in spending from 1987 to 2002 is due to increasing costs for the treatment of preventable and usually long-term conditions. The biggest culprit: obesity. We’re just too fat, Thorpe says. During this period, the percentage of overweight Americans rose 5 percent, while the number of obese individuals doubled to 24 percent. Spending on obesity rose from 2 percent to 11 percent, or from $3.6 billion to $36.5 billion. Related illnesses also rose — the treated prevalence of diabetes jumped 64 percent, for example. It was this leap in the prevalence of chronic illness, and not the cost for treating each case, that was the main driver behind the total rise in spending, says Thorpe. The cost per diabetes case in 2002 was $1,551, 20 percent higher than the 1987 figure of $1,293. At the same time, the prevalence of diabetes rose from about 2,400 cases per 100,000 individuals during the same period — a two-thirds increase. In other words, says Thorpe, the problem isn’t that healthcare is getting that much more expensive — it’s that Americans are buying a lot more of it. Tha< |
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