Americans
have yet to address healthcare efficiency as a priority. Health care reform
offers an enormous potential for boasting the economy's prospects. If we can
emulate Canada and only spend 11% of GDP on health care we would save $950
billion a year.[1]
In
the last five years I have been taking care of all aspects of my Dad’s
affairs.
The estimated economic value of unpaid work by some 42
million family caregivers in 2009 was $450 billion according to AARP. ...the
total Medicare spending in that same years was $509 billion ...nearly $ 3
trillion was estimated in lost wages, social security benefits, private pension
for men over fifty caring for their parents. Met-life estimates roughly $350k
for woman and $284K lost for man for a typical fifty -years and over caring for
their parents.[2]
Due
to being self-employed just a few hours a week has allowed me insight as my father’s advocate.
A large part of my father’s life was devoted to bettering the healthcare system
in the U.S. and it was indeed a challenge. Now he is nearly 91, I find as I care for him and myself it is no accident of our present healthcareless situation.
Many
years ago, the Washington Post referred to my Dad as “the unobtrusive shaper of
law.” He spent over four decades of his life writing major healthcare
legislation as a Congressional lawyer and researcher, including being a member
of staff on the House Ways and Means Committee assisting with all facets of
Medicare, Social Security, Disability Insurance reform and other endeavors.
Recently I applied to work for Encore.org since I have for 15 years looked for
full time work. My expertise is in
pollution prevention and recycling oil, paper and other secondary materials. My
past efforts in lessening waste and advocating resource conservation has not
translated in any job offers. Interestingly, my home town is where the first
Civilian Conservation Camp helped begin to employ millions during the
depression.
Presently
our economy totals 15 trillion dollars. U.S. total healthcare expenditure
is $2.7 trillion or 18 percent of GDP. It is forecast to reach 34 percent
of GDP by 2040. In 2010 Americans spent $1.3 trillion on healthcare.
Multiple chronic illness cases that are just one percent of healthcare
expenditure consume 21 percent of this total amount. The last tier of 50
percent of patients accounted for 2.8 percent of spending last year.
Contrary to popular opinion only 10 percent of healthcare dollars are
spent in the last year of life. While there is increased spending in the
last few months approaching death, it is not the massive percentage of medical
care dollars that is widely believed.
Healthcare spending is forecast to account for nearly 20 percent of gross
domestic product (GDP), or one-fifth of the U.S. economy, by 2021. It’s
been estimated that wasteful spending may account for between one-third and
one-half of all U.S. healthcare spending. The largest area of waste
is ‘defensive medicine’, including redundant, inappropriate or unnecessary
tests and procedures. Other factors that contribute to this excessive spending
include non-adherence to medical advice and prescriptions, alcohol abuse,
smoking and obesity.
A chief factor of the high costs is that in the United States-- compared with
other industrialized nations--we do not monitor or intervene in medical
pricing, aside from setting payment rates for Medicaid and Medicare for older
people and the poor. We allow for this government waste. Many other
countries deliver healthcare on a private fee-for-service basis, as does much
of the American healthcare system.
Why is there not new employment opportunities making our health care more
efficient and less wasteful? How is medical overspending monitored? Who
is questioning what care is of benefit and whether it is truly
needed? Whose role is it to make our medical care more
efficient? How can we determine what tests and procedures will
benefit the patient in question? Do certain operations, medications and
devices add to the better quality of life of the given patient? The
bottom line is that we the people must act in reducing these galloping
healthcare costs.
Why do Americans pay more for medical care than other people in other
countries? Ironically, we prescribe more expensive procedures and tests
whether or not other countries operate a private or national health system.
There is a need to best account for who is responsible for controlling
healthcare costs including lawyers, doctors, insurers, hospitals, drug makers,
and patients.
The United States spends about 18 percent of its gross domestic product on
healthcare: nearly twice as much as most other developed countries. The
Congressional Budget Office has said that if medical costs continue to grow
unabated, “total spending on healthcare would eventually account for all of the
country’s economic output.” Federal spending on government healthcare is cited
as a primary reason for long-term deficits.
American
medical companies can set charges for their products without marketplace
competition and government intervention. Contrary to the economic laws of
supply and demand, many healthcare products can remain overpriced and even
increase in price over time instead of dropping. For example, the price of a
total hip implant increased 300 percent from 1998 to 2011 according to
Orthopedic Network News.
Presently many payments are negotiated between a doctor, hospital or pharmacy,
and an insurer. Insurers have constrained ability or incentive to get the best
price, and they can raise premiums to cover costs.
Who is advocating for the consumers? While doctors may agree that they have a
responsibility in containing costs, actually doing this is another
matter. They also cite awareness of the costs of tests/treatments they
recommend.
Most physicians may agree to strive in the best interests of their individual
patient’s; however, what specific procedures and tests they give them is all
over the board. Whether they focus on cost management and also juggle
what is in the best interests of their patients is questionable. Physicians are
concerned about financial losses as a result of cost reduction efforts.
While employers are educating their patients to healthcare costs, many doctors
advocate for better healthcare cost management.
Greater awareness of medical costs and understanding the true price of such
care will lessen overspending. Changing doctors, consumers’ and insurance
companies’ attitudes regarding lesser costs and motivating better care given
limited resources is a huge social and economic issue requiring common
political will.
Today
the United States spends 5.6 percent of the national healthcare spending, or
$113 billion, on mental health treatment. Most of this goes toward
prescription drugs and outpatient treatment. Our country had 156,300 mental
health counselors in 2010, and access to mental healthcare is pathetic compared
to other types of medical services.
It
is difficult to find any peace of mind with our mental healthcare system. For
example, how depression, anxiety and other ailments directly affect our
bottom-line can only be speculated. Also, the degree to which such mind
states related to obesity and other major diseases today is difficult to track.
Loss of worker productivity and other indirect costs for mental treatment,
therapy and other associated facets of mental illness are difficult to fully
measure.
Mental healthcare is expensive, with 45 percent of the untreated citing cost as
a barrier. A quarter of the 15.7 million Americans who received mental
healthcare listed themselves as the main payer for the services according to
one survey that looked at those services from 2005 to 2009.
Greater information regarding expensive treatments with no proven benefits
allows the public to better evaluate their treatments options. If consumers,
the patients, can see prices before services are provided, that can help create
better value. Presently patients see little of what their full medical
costs are. Improved quality data on hospitals and doctors could better the
medical marketplace. Patients with insurance pay a tiny fraction of the
bill, providing scant disincentive for spending.
Presently
my health care consumes well over one-third of what I earn. For many
decades I worked in resource conservation. Medical overspending today is
just another reason to champion the value of waste reduction. Perhaps I can
create some potential employment opportunities in advocating better healthcare
management practices, or even stress management options to the greater public.
I have spent thousands of hours exploring diverse areas of stress management
and mental wellness. For several years I taught mindfulness meditation at my
local hospital right across the street from the National Institute of Health
here in Bethesda, Maryland. Every day I exercise and best focus on how to
foster my own well-being. I also do this for many family and friends.
For last 18 years I have learned to better address my anxiety. I have
been fortunate to be able to cope with a more and more demanding world. I have
been reluctant to share my plight with my HMO and spent out-of-pocket tens of
thousands of dollars of my own money to manage my own mental health. This
exploration has been my most valuable financial investment since I have become
more mindful as to how to keep appearances up and costs down. However, stress
and increasing global tensions continue to augment as our population and social
conditions evolve. It is wise to question how we going to fix our healthcareless system so as to prosper in years to
come.
The sooner we Americans face this opportunity the
better we will be. I wish to employ myself in caring in this very
careless time. All Americans are mutually tied in what happens in
healthcare. Our very well-being and future prospects forces us to
courageously agree to transform this wasteful crisis—into a new frontier of
opportunities. If only we can collectively care together will such new
jobs emerge. I will work to better
care for myself, my family and country.
