The Trial and Tragedy of the Medical Fiscal Cliff
Healthcare costs are leading us for fiscal disaster in this country. This is only the first trial/tragedy.
The inflation rate for healthcare costs has usually been 2-3 times the general inflation rate during my thirty years as a physician. We now spend twice as much per person on healthcare as the average per person cost of all developed countries.
Obviously, this level of healthcare cost will be ruinous.
The human costs are, however, the more important tragedy.
Even though we are the richest country in the world, we are the only developed country in the world that does not have universal health insurance. Unbelievable! Currently, 40 to 50 million Americans have no health insurance largely because they or their employer can't afford it. With the costs to every business, whether or not they provide health insurance to the employees now set at $63/head, there appears to be little hope of stemming the tide of rising costs.
Healthcare cost crisis will drive us to a real fiscal cliff within 10 years unless we get really behind the concept of proactive preventative care provided in a setting of physician-patient mutual trust. Only in this "system" where trust abounds and "patients" become "partners" in a decision-making process that allows rational decisions to be made about healthcare – rather than the emotional decisions too often made today out of fear and/or greed.
We need to develop comparative data – and make it readily available – that tells us what works and what does not, in other words what is "cost effective." Medical homes need to be able to explore what services really do improve outcomes. This information needs to be gathered, analyzed and best-practices standardized.
Any proposals about healthcare reform needs to be evaluated on the basis of how well they promote this kind of primary care. I have come to believe it is our only hope in mitigating cost while actually improving care.