We Have Too Much Healthcare and That’s a Problem

On Target Article – Tide is Changing

Robert J. Ault, D.C., M.B.A., CCSP

As a follow-up to the article I wrote, in the last issue of On-Target, regarding healthcare and technology, Amazon, Berkshire Hathaway, and JPMorgan are now joining forces to take on the healthcare industry.  The CEO’s of these powerful companies, Jeff Bezos, Warren Buffett, and Jamie Damon have publicly stated that they vow to use “technology” as their main method for solving the healthcare riddle.

I have to again, reiterate my position from my last article, which is… technology is not the answer to fix our healthcare system.  There is no doubt that Bezos, Buffet, and Damon are the titans of their industries, but retail, investing, and banking are not healthcare and thus technology alone cannot solve the healthcare industry. 

Let me ask any of you practicing chiropractors who’ve ever switched over to Electronic Health Records from paper charts.  Did your EHR raise your expenses (cost of the software, data management, PC’s, IT professionals) even though you were promised that EHR’s would lower your costs?!  Exactly.

Sure, healthcare is a messy industry, and yes technology can increase some efficiencies in our offices, but a main driver for fixing the ballooning costs of our healthcare system, technology is not.  I would make the argument that the healthcare industry would better be fixed if there was just “less” of it. 

There is too much healthcare in this country, and that is a problem.  A value-driven approach has the potential to fix this broken system.  On the surface, what I just said may sound crazy, but read on and maybe I can convince you.

Americans filled a record 4.5 billion prescriptions in 2016, that is nearly double the 2.4 billion filled in 1997, according to Consumer Reports.  Did disease in our nation double in the past 20 years?!  The answer is of course no.  What we have on our hands is a crisis of what is appropriate for a patient.  Consumer Reports stated that more than 50% of all Americans are on four or more prescription medications.  This is a sign of how entrenched our problem has become.  Our nation has created the “medicalization of daily life.”

I have no doubt that Amazon, Berkshire Hathaway, and JPMorgan can easily influence and lower healthcare costs, by negotiating lower bulk pricing and reducing supply chain costs.  I can also easily see them muscling out the pharmacy benefit managers, and insurance middlemen to lower the costs of prescription medications, but the real question should be… Do people even need these medications?  As chiropractors, we already know the answer to this question.

We cannot forget that medications cause health problems as well.  The opioid crisis just happens to be one of the many expensive and deadly problems that have developed due to overprescribing and thus “too much healthcare.”

If Jeff Bezos wants to be a true innovator and disruptor to the healthcare industry like one very famous disruptor, B.J. Palmer, then he needs to start listening to the healthcare providers that are on the frontlines of this battle in his own state. 

According to a new detailed report provided by 21 Washington state physicians, who are part of the non-profit, Washington Health Alliance, 45% of the healthcare services that were provided were, upon examination, determined unnecessary.  It showed that 600,000 patients in Washington underwent medical services that they did not need at a cost of $282 million in one year.

When these costs were broken down, examiners found that 22% of prescription meds, 25% of medical tests, and 11% of medical procedures were unnecessary. 

Let us not forget that the 3rd leading cause of death in the U.S., behind heart disease and cancer, is medical care.

For years the question has been, “How do we pay for the broken healthcare system?” Perhaps the real question should be, “How do we fix the broken healthcare system?”

The answer I would start with would be to expand payment models for rewarding those health providers that are delivering high-value and low risk healthcare options to their patients, and not just dishing out “more healthcare.” 

If there was only some type of healthcare discipline that existed in our country that was high value, extremely low risk, and much less expensive than traditional medical care…