Spending on health care has consistently grown faster than the rest of the U.S. economy. What’s behind this trend is less certain, though. Economists point to two causes: the prevalence of diseases and conditions afflicting the U.S. population, or the rising costs of treating diseases.
New research from American University Associate Professor Martha Starr and Virginia Tech Research Professor Ana Aizcorbe shows it is the latter, with higher prices for treatment accounting for 70 percent of growth in health care spending.
“Rising costs of treatment have had a much greater impact on driving up average spending than increased disease prevalence,” Starr said. “To tackle the problem of health care spending from a policy perspective, solutions need to focus on slowing growth of spending on procedures, treatments, and drugs used to treat given diseases and conditions. Of course, slowing or reversing the rise of chronic conditions would be beneficial for the health and well-being of the U.S. population, but by itself it won’t put much of a dent in health care spending growth.”
How about we cut the Red Tape, then?
The research findings appear in the May issue of Health Affairs. The researchers examined data from four nationally representative surveys from 1980 to 2006. They analyzed how shares of the U.S. population afflicted with different diseases and conditions and the costs and services used to treat them contributed to growth in average spending on health care, adjusting for inflation.
“In contrast to earlier studies on health care spending, we analyzed data that covered a longer time period and the full range of health care cases,” Aizcorbe said.
Over the whole period, rising disease prevalence boosted spending by 0.5 percentage point per year compared to a contribution of 2.5 percentage points from rising cost per case, the researchers found.
Costs of treatment have increased due to both rising prices of health care services and more intensive use of services to treat diseases.
Particularly hefty growth was associated with rising average costs of routine care, which more than doubled over the period to $602 per person per year in 2006.
Keep in mind that current doctor workloads are burning physicians out of practicing at all. And that every day, fee-for-service doctors do TWO HOURS OF TRANSCRIBING, just to get paid. They then have to increase costs for uninsured patients just to make up the difference for what insurers refuse to pay them.
It’s like we’re living in an arms race of costs.
Increased cases of chronic conditions such as diabetes, heart conditions, high cholesterol, and mental disorders boosted health care spending as well, but in a much more modest way.
However, they are costs. Even if they aren’t the highest contributing factors of rising healthcare costs, they still costs lives, and quality of life.
And it’s a known fact that if we can see patients, and listen to them, we can, overall, lower the occurrence of these conditions.
When examining rising health care spending, economists look at population aging and shifts in insurance coverage. Starr and Aizcorbe found these played minor roles over the 26-year period. And even though rising disease prevalence from 1997 to 2006 stood out, it still accounted for only one-third of average spending growth. The researchers also noted that had there not been a steady shift away from the use of hospital services, the rate of spending growth would have been well above 3.5 percent per year.
Reesearchers warn that even while shifts from hospital-based care to office-based care and prescription medicines for diseases and conditions may lower health care costs, intensified use of these services could drive up costs.
Well, not if a subscription model is implemented.
They also warn that the use of “more expensive items,” such as brand-name instead of generic medications, risks driving up costs, too.
Maybe tell that to big pharma. Consider, in the US, drug companies spend $19 billion a year on promotions.
Traditional health-care delivery systems focus on treating the sick and injured. But what about keeping people well?
The Commonwealth Foundation admits, “Although primary care is fundamental to health system performance, the United States has undervalued and underinvested in primary care for decades.”
Starr says it best here:
“Going forward it will be important to make sure intensified efforts to promote preventive care do eventually work to slow growth in spending on acute care.”
Hmmm. Here at Atlas MD, we pay three and 1/2 cents for an EKG strip, two dollars for an A1C test, a buck for a lipid panel. And we charge our subscribers nothing for them.
Hopefully, researcher Starr explores Direct Care in future studies.