2.2 trillion reasons to reform health care
Post-Dispatch file photo
A new Congress convened in Washington this week with health reform among its top priorities. That means finding a way to cover the more than 46 million Americans who are uninsured — and helping millions of insured families who struggle to pay the cost of their own care.
Those are the easy parts of health care reform. Solving them requires only money and political will.
The really tricky part of health reform is illuminated in a new report that breaks down U.S. health care spending, which reached a staggering $2.2 trillion in 2007.
The good news, such as it is, is that spending on doctors, hospitals, nursing homes, drugs and medical research grew by the smallest amount in nearly a decade — 6.1 percent, or $128.5 billion. That’s more than twice the overall rate of inflation.
The bad news is that even with more than 46 million uninsured and lower average life expectancy than most other developed countries, we managed to spend about $7,421 for every man, woman and child in this country.
The situation isn’t hopeless. Health reform won’t reduce what we spend on health care, but in the long run, it could help slow the growth. More important, it can refocus spending on better care so we get more for the enormous outlays we make.
Roughly one of every six dollars in the U.S. economy is spent on health care, figures in the new report show. That includes public funds for Medicare and Medicaid and non-government money spent by businesses and families.
Spending on prescription drugs grew at a relatively modest 5 percent, compared to 8.6 percent in 2006 and as much as 12 percent in 2004. Economists who compiled the report, published this week in the journal Health Affairs, say that is why the rate of health spending growth slowed.
Helping to slow the growth of prescription drug spending was the appearance of generic versions of several blockbuster drugs, including the sleep aid Ambien and the antidepressant Zoloft, in 2007.
Consumers also were choosier about filling prescriptions in 2007, in part because of concerns about safety. The U.S. Food and Drug Administration issued about three times as many “black box warnings,” which caution about the potential for series side effects and death, as it did in 2003.
But spending on prescription drugs accounts for only about 10 percent of the nation’s overall medical bill. Spending on hospital care, doctors’ services and other components grew even faster.
As we’ve said before, reform efforts should be focused on what we get for the money we spend as much as on how much we spend. That hasn’t always been the case in years past.
It makes sense to pay doctors for keeping their patients healthy instead of for treating patients when they’re sick.
It makes sense to better coordinate care so there’s less waste and duplication and to encourage more medical school graduates to become family doctors instead of specialists.
The paradox of health spending is that more doesn’t necessarily equal better. The real health reform challenge is to improve quality. We’re already spending plenty for care.
And do not forget that it makes sense to put a cap trial lawyer lawsuits against doctors and drug companies. While you cheer when some doctor gets hit with a large malpractice suit, you cannot forget that the cost of that lawsuit, the cost of the malpractice insurance, and the cost of those lawyers all goes right to the consumer of the health care.