Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

How Much Savings Is Left in U.S. Medicine? Lots

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

How Much Savings Is Left in U.S. Medicine? Lots

Article excerpt

Last week, two important reports underscored the potential for improving the value of health care in the United States.

The first of these, "Best Care at Lower Cost: The Path to Continuously Learning Health Care in America," issued by the Institute of Medicine, highlights two crucial facts.

The first is the health system provides a great volume of care that doesn't help patients.

The authors write "there is evidence that a substantial proportion of health care expenditures is wasted, leading to little improvement in health or in the quality of care. Estimates vary on waste and excess health care costs, but they are large" -- possibly amounting to more than $750 billion in a single year.

As the report notes, that is enough to pay the full salaries of all the nation's firefighters, police officers and emergency medical technicians for more than a decade.

Second, medicine is becoming so complex that it is virtually impossible for an individual doctor to keep pace -- especially without help from computers, the institute says. Consider that the number of medical journal articles has risen to more than 750,000 a year, from 200,000 in 1970.

"Diagnostic and treatment options are expanding and changing at an accelerating rate, placing new stresses on clinicians and patients, as well as potentially impacting the effectiveness and efficiency of care delivery," the report concludes.

This report reaches well beyond diagnosis, however.

It recommends sensible steps to move us toward a "continuously learning" health system. One of these is to give doctors and other providers expanded real-time access to the latest knowledge through the widespread use of clinical-decision-support computer software, bolstered by continuously updated data on clinical experience.

A second set of recommendations involves health care payment policies, which, as the institute argues, "strongly influence how care is delivered."

The U.S. needs to move faster away from paying providers a fee for each service and instead pay for what they accomplish toward helping patients.

The report also calls on health care leaders to promote and develop a culture of learning among doctors, while also empowering patients by giving them more information about their own medical decisions.

The second important health care report last week, published in Health Affairs, is based on a comparison of health care costs and quality among various regions. …

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