Healthcare expenditures discussion

Post your thoughts on the following:

• What are some of the contributing factors to the growth of health care expenditures?
• What are some measures being taken to reduce health care expenditures?

There are several contributing factors in the growth of health care expenditures. One of the largest factors is the overuse and inappropriate use of types of care, such as using the ED as a doctor's office.  Over the years people have wanted selective, specialized care rather than utilizing family physicians, or primary care physicians. This has in effect caused more of our medical school students to choose a specialty rather than in becoming a general practitioner. Specialists charge more per visit, thus driving up the overall costs of routine care. It is harder to get into these specialists, who as for referrals on new patients. This decreases the access for patients to obtain preventive and primary care that can potentially prevent ED use, and/or hospital admissions. Because of the expense of these higher priced specialists patients are more reluctant to be seen faster, and will wait until their symptoms worsen. Thus, these patients who cannot afford the routine visit are at a higher risk for complications of any illness not just chronic. Older patients with insurance such as Medicare, possibly see several doctors who do not coordinate the care of the patient. This is not safe, can be conflicting, and some may even duplicate tests, etc. There are physicians who receive payment incentives for delivery of more services. Some of these doctors provide these services without thought to cost effectiveness, or the overall necessity. Unnecessary services or tests drives up the cost for everyone. Then of course there is the cost of new and innovative technology. Not to mention that providers are having to turn to electronic medical records. Switching over paper records into electronic ones is expensive. This does not even cover all the increases in health problems like obesity, which alone can cause several problems.

Along with there being several contributing factors, there has to be several measure taken to reduce the health care expenditures. One of the measures can be in those physicians who do receive incentives to only get paid if they provide effective care. A focus of the new health care reform is for patients to have a primary care physician. In order to do this it would be necessary to promote and invest into having a patient-centered primary care system. One of the measures being done is in information technology. The change from paper records into electronic records makes it easier and medical records more accessible to several providers at a click of a button. Physicians and hospitals will be held more accountable for the treatment they provide. One of a major measures will be in price competiveness. Insurance companies are seeking treatments for patients even in other countries for things like major surgeries. They even pay for the patient's trip expenses. Planet Hospital is one of the companies that aids patients in finding treatments in other countries. The name of this type of care Planet Hospital calls "medical tourism".

Planet Hospital, (2011). Medical Tourism. Retrieved from http://www.planethospital.com/2009_v2/aboutmedicaltourism.php

Reflection:

I think the overall consensus is that big business, etc has been the brunt of the misconception of causing all of the increased costs. I am also seeing that the costs of medications in this country is out of proportion compared with other countries, even on the same drugs. In my own medications for migraines I have seen the location of Imitrex being moved from England to the Philippines for manufacturing. Did the cost of this medication go down? No, it actually went up, and is does not seem to be as effective as it once was. I am not sure why the effectiveness of this medication changed. I continue to read articles by the public media, in Health Leaders magazine, and in industry Insurance magazines regarding the ever increasing pharmaceutical costs. In the US we spend 30-50% more on medications than other countries. (OECD, 2009) Are the ever increasing costs of our nation's health care due to aging? ( OECD, 2009). I am inclined to say no, not by itself. It may be a contributing cause, but not any one thing by itself caused the increase.

OECD, (2009). Disparities in health expenditure across OECD countries: Why does the United States spend so much more than other countries? Retrieved from http://www.oecdwash.org/PDFILES/Pearson_Testimony_30Sept2009.pdf