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Many experts say healthcare system inefficient, wasteful

Posted Dec 04 2008 11:08am

An op-ed piece from The Washington Post (11/30/08) begins, “Talk to the chief executives of America’s preeminent healthcare institutions, and you might be surprised by what you hear: When it comes to medical care, the United States isn’t getting its money’s worth. Not even close.”

“There is more than enough money in the system,” said former House speaker Newt Gingrich, who runs the Washington, DC-based Center for Health Transformation. “We just are not spending it well.”

One idea, in addition to pay for performance, is to focus on wellness and prevention of chronic diseases, such as heart disease and diabetes. Another idea is to alter the payment of physicians, to ensure we’re not paying them based on the volume of patients treated but rather patients that we can safely keep out of doctors’ offices, imaging centers and hospitals.

“The current system is very hospital-centric,” said Donald Berwick, president of the Institute for Healthcare Improvement in Cambridge, MA. “We wait for people to get sick, and then we invest enormous sums to fix them up. We should build primary care as the core.”

These enormous sums may come in the form of over treatment, which, according to John Halamka and Rick Parker on The Health Care Blog, includes over ordering expensive diagnostic tests and the prescribing of expensive and sometimes unneeded therapeutics. It’s an epidemic problem, they write.

President-elect Obama seems to agree. In his third press conference since winning the election, he advised last week that he and his staff would ferret out wasteful spending wherever it was.

With healthcare costs in the U.S. currently approaching 17 percent of the GDP with projections toward 20 percent in a few years, it will be interesting to see where, when and how these cuts are made.

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