“I guess if a man lives long enough,
he gets to see everything. And I
mean everything. What else do you
have in your bag of tricks, Mr. Gekko?”
–Carl Fox, Wall Street
Now that you’ve had time to look over yesterday’s pledge by a coalition of healthcare industry trade groups promising to slow the rate of increase in healthcare costs by $2 trillion over 10 years, I have a question for you: Is this realistic?
Don’t answer right away. Instead, take a close look at the bullet points below–quoted directly from the letter sent to President Obama by six trade groups, including America’s Health Insurance Plans, American Medical Assn., American Hospital Assn., and the Pharmaceutical Research and Manufacturers Assn.–which in broad strokes outline the proposed path to big savings:
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“Implementing proposals in all sectors of the health care system, focusing on administrative simplification, standardization, and transparency that supports effective markets;
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“Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency;
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” Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies; and,
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“Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms.”
Now I know you can all quote me extrapolated statistics on how much we could save if every doctor followed evidence-based medicine, if every hospital and physician’s office had a fully integrated electronic medical record, if we all led healthy lifestyles, if we maximized clinical quality and administrative efficiency, and so on.
I’ve seen those numbers too. That’s not what I’m asking. And I’m not asking you to quote some big number and then say, “Well, if we only achieve half or even a quarter of those savings….”
What I’m asking is the following: Given the structure of our healthcare system, given the way healthcare is financed, given the built-in incentives, given the dichotomy of healthcare as “consumer product” vs. “human right” (and all the attached emotion therein)…given all this, do you think the industry’s voluntary pledge will achieve the promised savings?
As you can sense from how I’ve framed the question, I’m skeptical. It’s funny how nowhere in the letter to Obama are the words “sacrifice,” “tough decisions,” or “shared responsibility”–as if technology, innovation, and the ability to affect behavior change (i.e., alter human nature) can solve everything….as if we can achieve the necessary savings without someone feeling the pinch.
But the coup de grace was the penultimate paragraph of the letter. “However, there are many important factors driving health care costs that are beyond the control of the delivery system alone. Billions in savings can be achieved through a large-scale national effort of health promotion and disease prevention to reduce the prevalence of chronic disease and poor health status, which leads to unnecessary sickness and higher health costs. Reform should include a specific focus on obesity prevention commensurate with the scale of the problem.”
In other words, the industry is saying that if all its efforts to address the U.S. healthcare crisis fail it’s not the industry’s fault, it’s yours. Well, I suppose somebody has to take the fall.
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