HIT around the globe: Why is America's healthcare cost so high?

There are many reasons why our country’s healthcare costs are so high. Just look at the numbers: Globally, the average healthcare expenditure per capita is less than $1,000. In the US, it’s more than $8,000. Japan spends a bit more than $3,000 per capita; Brazil less than $1,000, and the U.K. a bit less than half of what we do.

One reason: Americans spend more on seeing doctors, particularly specialists. As an American abroad, I see that we go to the doctor more often than others. In Europe, for instance, people can go directly to the pharmacist for routine conditions, such as the common cold, while in the US, our first thought would be to go to the doctor’s office.

Here, it’s more expensive to operate a medical practice. Billing requirements, meaningful use, HIPAA, and expensive malpractice coverage all factor into a higher cost structure. These costs, when applicable, are much lower outside the US. And everyone along the chain typically “takes a piece” for their profit, executive compensation and other outlays that do little to improve patient health.

And what about the health of the population itself? Obesity, hypertension, diabetes and other conditions are the result of the caloric tidal wave coming out of our agricultural-industrial complex. Ahhh, corn syrup solids and their derivatives. Calories without benefit. And, if those get to you, just watch the set for a while, see an ad for a drug that will fix everything, and run off to get what you need.Wellness, schmellness.

How do we change this?

Patient engagement? Where are the incentives? After all, nobody does something for nothing, do they — even if the doing of it would improve the quality of life, reduce costs, or have other “non-financial” benefits?

Will more requirements for reporting, interoperability, meaningful use of electronic systems, a new diagnosis coding system, or all the other new initiatives lead to better health at reduced costs?

And, don’t get me started on “Big Data.” What are we going to do with all the — buzzword alert — predictive analytics that are supposed to lead to better outcomes? Fine, we can get better reports about trends, but how do we change behavior by patients and caregivers that lead to better results at more reasonable costs?

Give providers, and patients, the tools they both need, at the point of care and afterward, to actively participate, together, in improving health and reducing the cost of care.  

None of these challenges are easy. But then again, if medicine were easy it wouldn’t take years of training, followed by sleep-deprived internship and residency to develop the skills needed to care for patients. Let’s make sure we deliver tools that provide caregivers and patients with what is needed, when it is needed, immediately, and in a manner that doesn’t slow the process down or get in the way.

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