Frectally speaking

This month of November 2012 has seen a couple of significant events.

In the US we have seen the re-election of Barack Obama for a second term, though his first task post election is to face into a “fiscal cliff”.
In Europe we have seen ongoing economic challenges within the EU, with a recent EU budget summit ending in failure.

What relevance do these events have to any of us at a grassroots level?
Well several years after the global financial meltdown of 2007/2008, it demonstrates that the science of economics is still not agreed on a “spend or save” strategy, to get the Western world away from its history of excess..
The recurring theme for the West is how to work smarter…how to progress towards more efficient economies..?

In that context there has been a very clear report on the state of the healthcare sector that is worth a read. Its a report based on the US healthcare system, yet it makes a point that I believe applies to much of the developed worlds healthcare systems.

Named “Better Care at Lower Cost”, it highlights the shocking figure that up to $750 billion (yes billion) dollars are wasted every year within the US Healthcare System. That figure is worth a moments reflection… so too is the keyword waste..

Depending on your point of view that figure either represents a great big market opportunity or simply a big pile of waste. From a related commentary about these irresistible forces that will change the US HealthCare system, Brian Klepper makes the point that;

“Health care’s ever-increasing revenue growth has come at the expense of individuals and firms that pay its bills, directly through health plan premiums, and through taxes, often instead of buying other goods and services. It transfers wealth to health care from everyone else. Like the finance services industry, health care has become a disproportionate “taker” industry, sapping economic vitality from America’s communities.”

So its coming time for some hard discussions on how much economies spend on their healthcare system.

Now we know that the US is a outlier in terms of its % GDP spend on healthcare and the mismatch between its spend and its outcomes, which are not particularly good. However the US is not alone in this regard. Other economies are struggling to contain their healthcare costs.

The key lessons from the Better Care at Lower Cost are useful in any setting. The key points being..

Complexity of Clinical Care:
Physicians in private practice interact with as many as 229 other physicians in 117 different practices just for their Medicare patient population

Cost of Care
For 31 of the past 40 years, health care costs have increased at a greater rate than the economy as a whole

They commend 4 key Characteristics of a Learning Health Care System as a way forward.

Culture
-Leadership-instilled culture of learning, supportive system competencies

Patient-clinician partnerships
-Engaged, empowered patients

Science and informatics
-Real-time access to knowledge, digital capture of the care experience

Incentives
-Incentives aligned for value, full transparency

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You can learn more from this excellent report at iom.edu/bestcare