Larry Williams/ Post-Dispatch
Whenever the subject of universal health care is raised — and it will be raised by the incoming Obama administration and Congress next year — the first question always is how to pay for it.
Americans spent more than $2.5 trillion on health care last year; that’s a 25 followed by 11 zeroes. And that was with 46 million of us without any health insurance. How much more would the nation have to spend to cover the uninsured?
One leading researcher says the answer is zero — if we improve the health system’s efficiency.
If every doctor and hospital in the United States managed patient care as well as the prestigious Mayo Clinic manages its patients, the study found, the nation could save a staggering $750 billion a year in health care costs — about $2,500 for every man, woman and child in the country. That would be more than enough to pay for universal health care. And the Mayo Clinic isn’t exactly known for substandard care.
This declaration might be dismissed as wishful thinking if it weren’t coming from researcher Dr. John E. Wennberg, the influential founder of the Dartmouth Atlas. It tracks regional variations in medical care, cost and quality.
Dr. Wennberg’s research has shown that, on average, care provided to elderly Medicare patients in
Miami costs twice as much per person as care provided to similar patients in Minneapolis. Yet all the additional spending in Miami produces no increase in the number of years the patients live or the quality of the rest of their lives.
For more than three decades, Dr. Wennberg has studied the different ways that different doctors treat the same medical condition. Not all treatments are equally effective, yet variations persist.
Over the years, Dr. Wennberg’s ground-breaking research has uncovered some surprising results. For example, spending more on health care and getting more of it does not ensure longer or healthier lives.
He also has confirmed that supply sometimes creates demand: The more hospital beds or CT scanners there are in a certain area, for example, the more likely it is that doctors will send patients to the hospital and prescribe CT scans.
Dr. Wennberg adds that the more specialists in a given region, the more frequently they are used. That results in higher costs, but it doesn’t necessarily produce better outcomes.
In a new report, Dr. Wennberg and his Dartmouth colleagues recommend organizing care along the lines practiced at the Mayo Clinic and a number of other high-quality health systems. Mayo and comparable operations have clear guidelines about when and where to refer patients to specialists and admit them to hospitals and when to order sophisticated tests and treatments.
The care too many Americans receive is poorly organized and uncoordinated, Dr. Wennberg and other experts say. Some effective initial treatments are underused, and too much high-intensity care is delivered later.
Changing these patterns probably would require changing how doctors and hospitals are paid. Instead of receiving fees for treating illness, they should be paid to keep patients healthy — for providing recommended health screenings and counseling patients on diet and quitting smoking and other unhealthy behaviors.
Dr. Wennberg also recommends continuing research into the most effective treatments for diseases and conditions so that the care provided actually accomplishes the goal.
The good news, most experts agree, is that making the health care system more efficient would result in enormous savings — enough to cover every American. The bad news is that, unless we start changing soon, we risk the collapse of the health system on which we all depend.
garyro – It’s because of the skewed priorities of people like you that the newspaper industry is in such trouble. Maybe the problem is that you’re focusing on Eric Mink and Eddie Roth … instead, think of Bill McClellan and Ziggy. If you don’t think THEY are as important as health care, well, I just don’t know what to say.
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Nick
morning
” Being well informed is just as important as being healthy.”
Nick, I never equated reading the funny papers as important as doctor’s visit or getting an X-ray. Never equated reading the sport’s page with dental appointment (although I would rather read sports that see dentist) Something to ponder.
Thought about it and sorry Nick, healthcare concerns outweigh funny papers in the great scheme of things.
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> you have a right to quality and affordable healthcare,
> you do not have a right to own a newspaper
The right I discuss here is to READING a newspaper, not owning one. Being well informed is just as important as being healthy. Why should the profiteering and inept management of the newspaper industry stand in the way of that important right?
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Nick
Good satire. Lets use Tarp funds to buy up everything. Karl Marx would be proud.
One problem with your satire: you have a right to quality and affordable healthcare, you do not have a right to own a newspaper.
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Another report in 2005 from Boston said Americans are wasting 50 cents on every dollar spent on health care in the land compared to Canada. Plans to reform the national health care were on the Platform of the Bull Moose Party in 1912. See how far we have gone. Truman administration wished a form of Universal health care.
Merely another study that says we can do far better on medical care costs, something that might occur under an Obama administration.
Personally I prefer the Medicare for all Americans Act (Hb 676) approach. Failing that, socialized medicine like France begins to look more attractive as an alternative to the mess we have today.
By the way, if the big three fail and go bankrupt, another 750,000 and more will be without health insurance.
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The way I see it, the problem in health care is similar to the problem in the newspaper industry:
1. Unnecessary duplication. In some cities, there are multiple newspapers covering the same subjects. As a result, resources are diverted from other areas with no newspaper, or perhaps just a thin weekly edition.
2. Barriers to access. First, and most obvious, is the cost. In St. Louis, it costs 50 cents to purchase a daily paper. With people worried about escalating energy and food costs, mortgage and debt problems, and insecure employment prospects, this is a serious obstacle.
3. Lack of inclusion. Because of their narrow focus, many newspapers fail to include fair reporting about certain groups of society. Take the Post-Dispatch for example: There is far more reporting about African-American crime than about the many achievements of those in the African-American community. And aside from a few controversial photos of the Pridefest parade, the LGBT community is practically ignored.
The solution to this is very simple: The government should use stimulus money to take over the newspapers, and run the papers themselves for the benefit of the public rather than the private profit of corporate shareholders. This strategy could eliminate duplication and corporate inefficiency, provide greater public access to newspapers, and provide proper coverage of neglected groups.
One good example: Money from the stimulus fund could be used to purchase Lee Enterprises, owner of 51 daily newspapers and 300 weekly publications in 23 states. Current market capitalization is just $17.58 million. Bernanke probably has that much change in the cupholder of his limo. Chairman and CEO pay were not disclosed, but the 3 VPs collected a total salary of more than $1.2 million. Put those guys on civil service scale, and use the savings to provide free newspapers to the poor.
Now, Lee does have $1.37 billion in debt, but the feds can take care of that too. After all, what’s more important to America, 51 daily newspapers or a few auto companies? On any given day, a lot more people purchase newspapers than cars. So obviously, newspapers are more important. And the TARP funds were to be used to purchase “toxic debt.” Let’s be honest, a $1.7 billion loan to a newspaper holding company is MUCH more toxic than a $75,000 mortgage to somebody with no job or assets. At least when the bank forecloses on a house, they get a house. What would they get if they foreclosed on Lee, the weatherbird?
So let’s push this one forward. Perhaps Senator McCaskill could bring this up in her next meeting with Mr. Obama. Use TARP funds to take over Lee Enterprises, and let’s provide quality newspapers for every American!
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