Judson Haims: Is health care getting too big? (Part 2)
July 16, 2018
Today's article is a follow-up from my July 3 column: "Is our health care system too big to change?"
Regardless whether your employer contributes to your health care costs or if you pay for it alone, it is hard not to be aware of the exorbitant cost. According to a report from the Colorado Health Institute titled "2017 Colorado Health Access Survey: The New Normal," insurance cost for Colorado are at historic levels and no reprieve is in sight.
Our government is at an impasse and nobody seems able to push through the bureaucratic mess. Rather than sitting idle and continuing to pass blame on medical providers, big insurance agencies, pharmaceutical manufacturers,and the middle men who extort us, there are some mighty big companies and powerful entrepreneurs who are taking action to make remarkable changes.
As of July 9, Dr. Atul Gawande took the helm of a joint health care venture between Amazon, JPMorgan Chase and Berkshire Hathaway. The CEOs of these companies, Jeff Bezos, Jamie Dimon and Warren Buffett are visionaries and together, they have their sights set on bettering our health care system.
While not everyone may appreciate the ways which these titans of our world business have influenced our economies, each has proven that they can challenge the status quo and thrive when faced with formidable challenges. Our health care system may very well be thier most formidable challenge.
According to Dimon, "As employers and as leaders, addressing health care is one of the most important things we can do for our employees and their families, as well as for the communities where we all work and live."
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We've created so many layers of unneeded health care. We must simplify and there is a great chance that Dr. Gawande will do just this. As Dr. Gawande said at the Aspen Ideas Festival, he will start by addressing three sources of waste in the health care system:
1. Very high administration costs and a lot of middle men.
3. Misutilization, which means the wrong care at the wrong time and the wrong way.
Administration costs and middle men may be some of the most daunting challenges to change. How many times have you visited your doctor and noticed that they are so busy typing away on the computer that they spend little time talking and having eye contact with you? It is not by choice, I assure you.
Regrettably, medical providers too often spend more time on paperwork than they do attending to patients. Although they want to provide personalized care, they are often faced with many challenges along the way. For example, while electronic health records were meant to aid doctors by providing detailed medical history, they now predominately serve as documentation for billing and quality reporting.
Pricing and misutilization also pose forbidding challenges. Changing the distribution channels of medications from manufacturer to consumer, renegotiating how pharmacy-benefits managers dictate what drugs will be covered by our insurance providers and what we will pay for them, along with addressing the dogmatic ideologues of our politicians will likely keep Dr. Gawande, Bezos, Dimon and Buffett quite busy.
Misutilization may very well be the greatest and most important challenge facing Dr. Gawanade's new venture. Our current medical system promotes redundancy, inefficiencies and a fragments delivery of care. Dr. Gawanade provided a personal example he witnessed when his mother received a recent knee replacement.
As he sat in his mother's hospital room, he took count of all the people who came in the room "to change the plan, make a plan or execute on the plan." In total, he counted 66 people.
He further went on to say, "Now, if you're paying every one of them individually, there were eight different physical therapists. One comes in the morning and says, 'What are you doing in bed? You should be out of bed.' One comes in the afternoon, 'What are you doing out of bed? You should be in bed.' You just want to say, 'Is there anybody in charge?'"
If Dr. Gawande proves to be successful, the answer to that question will be "yes."
(If you have not had the opportunity to read part 1 of this series, it may be found on The Aspen Times website.)
Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt and Carbondale. He is an advocate for our elderly and is available to answer questions. He can be reached at visitingangels.com/comtns or 970-328-5526.
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