The pivotal question hanging in the balance: How do we reduce healthcare costs? And to whom does the responsibility fall? Is it reigning in pharmaceutical companies? Is it improving and implementing state of the art health information technology (HIT)? Is it stopping insurance companies from gouging consumers? Is it encouraging physicians to stop practicing defensive medicine? Sure, all of these are reasonable ways to reduce costs and save the system some money. However, in this ongoing debate over healthcare reform, an important piece continually gets ignored. The less people get sick and have to visit a hospital or physicians office, the less it costs the entire system. Plain and simple. Decrease the demand with a stagnant supply and prices (or costs) will go down. Take any economics 101 class at a community college and you will learn this nugget of knowledge. The largest threat to decreasing healthcare costs is apathy and neglect from people towards their own health. PPACA offers no incentive (or disincentive) for that behavior to change. Reducing true healthcare costs begins with the patient. The rest is just healthcare financing, cost shifting and organizational development.
Creating an efficient and less wasteful healthcare model will undoubtedly help reduce spending.
Reducing unnecessary stays in the hospital and eliminating administrative errors, like billing fraud, will work to maximize efficiency. The continued proliferation of HIT will contribute to the effort by improving waiting times and increasing patient safety. But if the line of patients keeps growing, costs will continue to skyrocket and negate any savings seen by other efforts. Paying people less, a key government strategy in reducing costs, isn’t reducing a healthcare “cost”, it’s reducing a government expense. In some cases, it actually will punish a physician or provider who does their part, follows all the protocols, but a non-compliant patient keeps them from meeting certain “quality standards.”
What about the patient’s role in helping to reduce costs? In all the uproar over healthcare reform, the patient has been portrayed as the victim abused by greedy drug companies and forgotten by profit hungry insurance companies. A 10 year old with a rare genetic condition, a very unfortunate circumstance, is not bankrupting the system. What about attacking the high number of preventable illnesses and conditions that plagues and drain money from the healthcare system? The prevalence of cardiovascular disease, obesity, diabetes, joint injuries and other chronic conditions continue to increase and worsen because patients refuse to take care of themselves. Nothing in the PPACA bill will directly address and aggressively impact the near $147 billion in healthcare spending related to obesity other than the drugs might be cheaper. Giving more obese patients access to cheaper drugs will only serve to increase future spending. If we reduced the number of obese individuals, causing less demand for those drugs and other services, true costs would go down. Not to mention it may improve the quality of life for those individuals and their families.
Americans should want healthcare reform to address access to healthier foods, including fruits and vegetables, and promoting the LIFELONG benefits of exercise and a healthy lifestyle. Patients who don’t take care of themselves shouldn’t be treated like victims. If we continue down this path, the United States will have the most efficient, least wasteful healthcare system in the world with waiting rooms full of overweight patients with diabetes that smoke. Is that what we want?
