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Jan 20, 2009 06:15 PM | 20
Millions of people in the U.S. and around the world watched the historic inauguration of Barack Obama as he vowed to rebuild and reunite a fractured nation facing war, economic turmoil and other major challenges. Among the hurdles, our new President pledged, "We will restore science to its rightful place, and wield technology's wonders to raise health care's quality and lower its cost."
One needn't look far to see how technology has improved medical care – from anesthesia to ultrasounds. And some – Obama seemingly among them – believe that such technology can make health care more efficient. That could mean shorter hospital stays, more complete medical databases or ordering fewer tests because those we have are better.
But whether more technology will actually lower the overall costs of health care in the U.S., which top $2 trillion annually, is more of an open question. In fact, just the opposite may be true, according to a study published in Health Affairs in 2003 led by Lawrence Baker, a professor of health research and policy at Stanford University's School of Medicine in California.
That may explain why the U.S. has the highest per capita health care spending in the world but ranks just 27th in life expectancy. Number-one-ranked Japan spends just a third of what we do per capita.
So does Obama’s claim hold water? We asked Baker to respond to the new president’s comment. It's "where our country has to go,” he told ScientificAmerican.com. “There are huge technology opportunities out there."
But, he added: "The most health care isn't always the best health care. Decisions about value is probably the key," he said about keeping overall costs down. Providing the best and most affordable care will depend on finding and using the technology that makes the most sense. In order to do that, he continued, "We need to search hard and think hard."
The U.S. isn't alone in the battle to balance technological benefits with costs. "Changing demographics and medical technology pose a cost challenge for every nation's system," wrote Robert Kuttner, co-editor of The American Prospect, in the New England Journal of Medicine last year.
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20 Comments
Add CommentImproved technology can help, but we all know that most of our health problems in "developed" nations are related to lifestyle factors - obesity, diabetes, heart disease, alcohol-related accidents, even many forms of cancer. Money should be spent on preventative healthcare which encourages healthy eating, exercise etc. and investigating the impact of environmental pollutants and toxins (e.g. biosphenol) - an approach which is much more cost effective in the long run than trying to fix the problems after they've developed.
Reply | Report Abuse | Link to thisOf course Obama's statement would give comfort to the pharmaceutical companies and the medical technology companies don't want us to take responsibility for our health, and Obama's statement seems to feed into the myth that we must continue with a consumerist growth model and develop and buy our way out of our current problems. This model is unsustainable.
On the surface of it, Obama seems to have dropped the ball on this one, although let's wait and see his full health policy. Still, I'm glad to have him there.
I am posting a comment regarding the use of the word "can" in the title of the blog "Is Obama right that technology can lower health care costs?". CAN indicates that someone is able to do something (has the knowledge to do something), while COULD, the subjunctive mood variety of the word, indicates the likelihood of something happening. Given the variety of factors that co-determine health care costs, perhaps the author of the article intended saying "... technology could lower health care costs".
Reply | Report Abuse | Link to thisRembrandt Klopper
I am so happy to see this article. Health Care costs are so high for Americans because so few of us can even afford care. The quality of our health has declined and it is because for a long time inflation of the cost of living has outpaced increases in earnings. The less people make, the less likely they are to have access to health care and the more likely they are to to be overworked and they'll have weaker immune systems as a result. Then people don't go until the problems get really bad. Factor in all the obesity (thats due to unhealthy cheap food) and you have a health crisis. The increased infant mortality and ridiculous mental health issues are serious indicators too.
Reply | Report Abuse | Link to thisHealth care costs are so high because most people do not take the responsibility to maintain good lifestyle habit, ie stop smoking, avoid excessive weight gain, regular exercise, etc, and have high expectation from the health care system and its associated technology. In 1950's you would only be observed or had a skull xray should you fall and hit your head on the ground. Today the same incident would require complete medical data base with variety of tests, including CT scan or MRI of the brain, just to make sure that you did not have internal bleeding or would come back to file a medical malpractice suite for a "misdiagnosis". This type of attitude and litiginous medical atmosphere simply do not exist in many parts of the world, including Japan, UK, European countries etc. To indiscriminately increase the availability technology for any condition would simply open the gate for runaway healthcare cost, which would punish those who desperately need cost-effective therapy. The current policy of prior authorization / screening for procedures / therapy only results in more time lost to doing paperwork resulting in INCREASE cost and waste to everyone in the system. Don't be penny pinching but pound foolish! Healthcare is like a growing beast; the more you feed it the bigger it gets until it consumes everything in sight!
Reply | Report Abuse | Link to thisHealth care costs are high because of the ridiculous amounts of malpractice insurance doctors need now because of crazy sue-happy people and laws that don't do anything to protect the doctors. In the mean time, they know they can charge crazy rates because it's either that or your health... and in some cases, your life. If you want to reduce health care costs, the only way to do it is to improve the health of the nation as a whole. The best way to do that is through better nutrition. The proper diet is actually very simple: Eat food, not too much, mostly raw fruits and vegetables, some cooked vegies, some fish/eggs/milk, other meats very sparingly.
Reply | Report Abuse | Link to thisFrom there, our health should improve drastically, meaning we wouldn't need the majority of health care. Mainly heart disease, high cholesterol, high blood pressure, improper blood glucose, and common illnesses such as cold/flu would be almost unheard of if we ate properly.
Then you just get rid of the aldehyde producing ethanol in our fuel and ween the country off of coal to solar/wind and ignore biofuel entirely.
Then as a nation we should be plenty healthy. The reduced burden on the health-care system will help reduce the amount of accidents, which will reduce the malpractice insurance rates and the cost of health care. If laws also put a limit on the amount people could sue for when it comes to medical malpractice then that might be helpful as well. Keep in mind that medical mix-ups are the third leading cause of death in this nation. That's pretty scary really.
Technology will not help the issue... but it will make some people some money, but not the one's who need it.
Last year my doctor discovered an aortic aneurism so large it had to be operated at once. My surgeon and the surgical staff were "perfect." The care I received in the hospital was "4-1/2 Star." My recovery (12 weeks) went on schedule and w/o complications.
Reply | Report Abuse | Link to thisYet - the billing through the insurance company took months. The "net balance" turned out to be multiple net balances from each & every "office" which provided services on that huge "medical campus." I had to wait 5 months and made many inquiries trying to find out if "this is the last bill" from each office. Finally, I thought I had all the bills and made payment arrangements with all those offices. The following month: I got yet another bill from yet another office. Start all over again: only I "blew my budget" on those original billings. Inevitable: the late comer will turn my account over to a billing agency - who will pester me and damage my credit rating.
Great system. This malthusian "business model" one of the real reasons that "medicine" is screwed up. It interferes with good medicine and financially harms both care providers and their patients. In some cases, the medical / accounting computer systems are indistinguishable from those in the gift shop on the corner.
My girlfriend lives with untreated MS, and after a year of jumping through hoops and waiting, was flat out denied disability benefits. She deals with painful muscle spasms multiple times a day, but still works most of the week. On the other hand, some fat dude I used to work with bragged to me that he got on disability for 3 years for a "back injury" that he sustained after wrecking his car, then laughed and admitted he was fine the whole time.
Reply | Report Abuse | Link to thisWant to save some money? Start by making sure your programs are actually working.
Health care? You should have written "sick care."
Reply | Report Abuse | Link to thisHealth care happens at the gym, not in the doctor's office.
But yes, a central repository for patient data and insurance info would make hordes of admins redundant and give doctors far better information about the patient than they get from the multitude of forms you have to fill out today.
Oh, and if the patient data was tracked, the doctor could tell the patient during the next checkup that his/her higher weight, blood pressure or blood sugar will cost him or her X years in lifespan and Y dollars in "healthcare" bills. People just don't get it until it's too late.
Heath care costs have become insanely high because the industrialization of medicine has ruined the doctor-patient relationship. Advancing technology leads people to believe we know more about the human body than we really do. The appetite for new technology is insatiable. It is leading to an ever increasing passivity among both doctors and patients. Many medical decisions are now made by machines. Good health and well being come from self examination, a willingness to change and the prudent use of modern medicine.
Reply | Report Abuse | Link to thisThe very model of not having a single-payer system inflates costs, because some intermediate entity (insurance companies) needs to make a profit. Note also that 20% of insurance company budgets are spent fighting and stalling perfectly reasonable claims.
Reply | Report Abuse | Link to thisMedical databases could reduce costs, but only by a little bit.
For addressing lifestyle issues, "obesity taxes" on unhealthy food that would subsidize healthy food is a good way to go. Or increasing copays by the extra pounds one carries...that will give good incentives to many of us to zip it up.
The hard choice is to not spend so much effort, time and cost trying to postpone death in terminal cases. It is done a lot in this country, prolongs life only by a few months, taxes the system heavily, and usually does not increase the quality of life.
The blunt truth is that in countries with nationalized health systems, each person's life does not have the same value. Children and young adults with responsibilities come first, and old people come last. Life value is proportional to life expectancy if health is restored, and costs are allocated accordingly. Here it is the opposite.
From some of the other posts here, I see multiple points which need re-evaluation and change. I'm sure the new congress and administration will be working on a reform package "pretty soon." That said, it is up to responsible citizens to provide honest input with our representatives.
Reply | Report Abuse | Link to thisI also believe that an honest comparative study of medical systems in other countries should be done before congress embarks on re-inventing the wheel. I also have seen that the Republicans have been on the wrong side of the road in this regard: making negative assertions about other systems just because those systems don't conform to their ideology. Comparative analysis is still needed. As President Obama says, we the people have failed to make the hard choices. We have to "not care" if the "brand" is Canadian, Japanese or German: so long as we get a first rate system at a substantially reduced cost to Americans.
This is a good article, but I find that the posts in this forum much more interesting. We have some good points, but I have to wonder if ideas like this will even make it to the drawing table. If a few readers can generate these opinions and ideas, I have to believe that the administration has thought of it as well, and most likely rejected it. We will see.
Reply | Report Abuse | Link to thisAs for me, being in the tech industry, I don't rely on much home that tech will be a huge factor in the expense of health care (I like the term 'sick care'). Technology can be used to do things that are rudimentary, that apply to ALL or a huge majority. It is used to free humans of repetitive tasks so that we can think critically on something of more importance. I don't think relying on tech to diagnose is a good idea. Diseases/Sickness is too personal and don't behave in a repetitave case most of the time. What we need to do is to free up the doctors so that they can think about what the problem is.
This brings two more points. First, the easier we make the 'tests' and diagnostics, the more the doctor has to choose from. Maybe he will go ahead and order a couple extra tests if we hve the technology to do so, this can get confusing and distract from the actual problem. Second, let's look at the technology already in hospitals. Take an MRI for example. It is a huge benifit towards health careto be able to do things like this (not just health care, but for science in general), BUT the cost is through the roof. This is the case of technology that wasn't finished. Yes, we have the ability to use it, but it isn't pheasable. We need to continue that technology to lower the cost.
I believe everyone in this forum brings up a good point. The industrialization of health care and the health and habits of our nation are driving up the cost. Technology can improve this, but only if done correctly. If we don't use it properly, it can end up driving up costs and malpractice suits.
What stands in the way of U.S. health care reform? Vested interests!
Reply | Report Abuse | Link to thisEvery dollar spent on “health care” is a buck made by “health care” providers. And the health care industry isn’t going to relinquish their profits without a fight. They have money, and they are willing to spend it to buy off legislators, the FDA, the medical system and whoever else might get in their way. In addition, every technological advance brings new potential profits, i.e. an increase in medical care costs.
You might want to read the article “Health care reform – why so much talk and so little action?” by Victor Fuchs in the Jan. 15, 2009 edition of the New England Journal of Medicine. You can find it at http://content.nejm.org/cgi/reprint/360/3/208.pdf.
Let's keep this simple: science and technology are just tools we use to accomplish something. The results of the use of a tool (be it a hammar, a gun, or genetic technology) are largely based on the individual and collective values and priorities we bring to our decisionmaking about that use; i.e., what we get is based not so much on the tools we use but who we are as individuals and a people (or peoples). If we change to tools (technology) but not ourselves, we'll still get the same (or worse) outcomes.
Reply | Report Abuse | Link to thisTo Simultaneously Reduce Taxes and Health Care Costs
Reply | Report Abuse | Link to thisPresident Obama to a joint session of Congress September 10, 2009: (To our seniors)& dont pay attention to those scary stories&. these same folks&.just this year, supported a budget that would have essentially turned Medicare into a privatized voucher program. That will never happen on my watch.
This simple statement belies the Obama/Democrat pay to play health care scam. These people couldnt care less about the 20 million uninsured Americans (who currently are getting their health care for free). Instead, they just want to create another giant bureaucracy from which they and their lawyer pals can skim. And another giant bureaucracy from which they can draw votes and political power.
To simplify the 1500 page health care bill. And to reduce health care costs, simply provide current Medicare and Medicaid recipients with vouchers and let them buy, with these vouchers, whatever health insurance seems to fit their needs. And, simultaneously, end all Blue Cross/Blue Shield tax-exempt status. And issue a federal mandate that allows patients to cross state lines to buy whatever health insurance they wish.
In other words, break up those cozy, lawyer dominated BC/BS (in state) monopolies which drive costs so high. Like the scam that Kathleen Sebelius ran, with her lawyer pals in Kansas, for so many years. Ditto for the Medicare and Medicaid plans.
Wake up America! Simpler is better. Just remove the lawyers and the bureaucrats. And open the bidding. And bingo, the health care costs for patients and taxpayers, alike, will plummet. And our economy will recover. But do it the Democrats way and our current national economic downhill spiral will tragically accelerate.
George Meredith MD
Virginia Beach
In order to lower health care costs,you don't merely place a tax on fats,sugars, and starches.You CAP them...just like we're going to do with carbon dioxide.If you want to pollute your body with a snicker bar and cause your health care costs to go up...then someone else will need to offset your action by eating a stalk of celery..or a bowl of fiber -1 cereal .. or that someone else will have to do without some sweets..just to make sure that HIS or HER health care costs go DOWN.Perhaps,if you want to eat a slice of pizza,you'll need to get someone else to take an extra few milligrams of a blood pressure pill. Think of the fun the statisticians and bureaucrats will have!
Reply | Report Abuse | Link to thisAnd as for the lawyers...we'll see how much they like a single payer,federalized malpractice adjudication agency..complete with rules and regs as to what percentage of whites..or blacks..or hispanics..or South Sea Islanders win what percent of wrongful death claims or misdiagnosis claims.Of course..we'll have to make sure that everyone gets the same percentages..since everyone MUST have an equal outcome +/- some historical fudge factor congered up by liberal do gooders!
In order to lower health care costs,you don't merely place a tax on fats,sugars, and starches.You CAP them...just like we're going to do with carbon dioxide.If you want to pollute your body with a snicker bar and cause your health care costs to go up...then someone else will need to offset your action by eating a stalk of celery..or a bowl of fiber -1 cereal .. or that someone else will have to do without some sweets..just to make sure that HIS or HER health care costs go DOWN.Perhaps,if you want to eat a slice of pizza,you'll need to get someone else to take an extra few milligrams of a blood pressure pill. Think of the fun the statisticians and bureaucrats will have!
Reply | Report Abuse | Link to thisAnd as for the lawyers...we'll see how much they like a single payer,federalized malpractice adjudication agency..complete with rules and regs as to what percentage of whites..or blacks..or hispanics..or South Sea Islanders win what percent of wrongful death claims or misdiagnosis claims.Of course..we'll have to make sure that everyone gets the same percentages..since everyone MUST have an equal outcome +/- some historical fudge factor congered up by liberal do gooders!
Healthcare: Killing America
Reply | Report Abuse | Link to thisFOR MORE DETAILS VISIT IAIResearch.wordpress.com
Americans spent an estimated $2.5 trillion to maintain our health in 2009, or roughly $8,000 per person. This is more than the gross domestic product (what is spent on everything) in every other country in the world except Japan, China, Germany, France, or the United Kingdom.
Spiraling healthcare costs are on track to bankrupt America. Medicare will be insolvent by 2017 and is projected to generate a $37 trillion deficit. Increased healthcare costs are one more reason jobs flee America. And all this extra cost has given us very little return as most of the gain in life expectancy came during the first half of the 20th century due to improved sanitation and nutrition.
The cost of healthcare could be cut in half, but what do our politicians want to fix first? They want the most fraud-riddled, inefficient systemour governmentto take over more of our care! They want to cover 47 million Americans without insurance rather than fix the cost of care for all 307 million Americans!
We can drive down costs to levels that existed before government decided to fix healthcare in 1965. This means we all have to change:
� Consumers must live healthier lives, manage their own care, and bear more of the direct cost of care. We must remember that, insured or not, we pay for healthcare through lower wages, higher prices, or higher taxes.
� We must find a way to live our last years without bankrupting our children, our grandchildren, and our neighbors.
� Lawyers can no longer be allowed to pillage our medical system for private gain.
� Providers must take a lower share of our national wealth. In return they would become less likely to be sued, go unpaid, or bear excessive overhead costs.
� Government must back away from managing care and focus on policing illegal behaviors and driving efficiency through shared knowledge.
Most important, government and industry leaders must push for change that is good for the country rather than for political contributors and lobbyists. Our founding fathers realized our republic would only survive if its leaders possessed public virtue. This crisis is another test of that virtue and I fear as Congress buys each vote with special interest gimmicks, our nation is further undermined.
We are no less disabled by disease than citizens of most developed nations, and our medical care is, with few exceptions, no better at helping us survive specific diseases. There is a worthy national concern over health care costs, as they are the cause of 6 of every 10 bankruptcies, and send a lot of people running for <a rev="vote for" title="Health Care Costs Predicted to do Little for Debt Relief" href="http://personalmoneystore.com/Payday-Loans/"><strong>payday loans</strong></a>. However, despite the concerns and actions of Congress, it's estimated that the cost of health care is going to increase over the next few years. The hitch in health care reform is that the impetus seems to be throwing money at the problem, rather than finding out the cause of high cost and any doctor will tell you that you have to treat the disease before the symptoms.
Reply | Report Abuse | Link to thisWe are no less disabled by disease than citizens of most developed nations, and our medical care is, with few exceptions, no better at helping us survive specific diseases. There is a worthy national concern over health care costs, as they are the cause of 6 of every 10 bankruptcies, and send a lot of people running for <a rev="vote for" title="Health Care Costs Predicted to do Little for Debt Relief" href="http://personalmoneystore.com/Payday-Loans/"><strong>payday loans</strong></a>. However, despite the concerns and actions of Congress, it's estimated that the cost of health care is going to increase over the next few years. The hitch in health care reform is that the impetus seems to be throwing money at the problem, rather than finding out the cause of high cost – and any doctor will tell you that you have to treat the disease before the symptoms.
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