Don't let politics obscure important health care reform
Clarity of purpose in these chaotic political times is critical.
It's hard to understand what is going on in Washington with a new report coming out daily regarding who is willing to compromise what. We need to stay really focused now on the facts and what is most important in health reform legislation.
Fact #1: We spend close to 2.5 trillion dollars on health care in the U.S. This number is increasing at a rate of 6-8 % per year.
Fact #2: Depending on which congressional committee's bill you want to choose, proposed legislation increases this spending by 800 billion to 1.6 trillion dollars per year.
Fact #3: The proposed way to pay for the increase is through increased taxes and reduced reimbursement to providers.
Does this sound good so far? Wait.
Fact #4: There is no significant plan to reduce the continued increase in the cost.
We now have an approximately 3.5 trillion dollar entitlement that will be increasing at a rate of 6-8 % per year. This is simply not going to work. What should we do? Let's look at some more facts.
Fact #5: 80% of health care costs are generated by the care delivery system. 7% by health plan administration.
The point being we are not going to get cost savings out of the health plan to pay for coverage it is only going to come out of the delivery system. We must begin to eliminate waste from the delivery system if we have any chance of managing the cost.
Fact #6: Approximately 300 million medication errors will be delivered in the American Health Care System this year.
Many other mistakes lead to high cost in health care. Examples include infections after surgery, patient falls, pressure ulcers and many others. We've known for years that we were injuring and killing many patients per year. In fact estimates for injuries are as high as 15 million/yr.
Fact #7: There are a core set of early adopters of the principles of manufacturing quality called "lean" which are showing dramatic reductions in these defects and in the costs of delivering care.
This group of organizations has created the Health Care Value Leaders Network www.healthcarevalueleaders.org They are committed to transforming their organizations to the safest and most reliable in the industry and they are proving that it's possible to do so.
Fact #8: ThedaCare in Appleton WI, one of the 16 organizations has reduced the cost of inpatient care by 25% and improved quality on their med surg unit to near 100% reliability. Isolated Coronary Bypass surgery mortality rates have dropped from over 4% in 2001 to 1.4% in 2008 and 0% so far for 2009. Gundersen Lutheran in LaCrosse WI, takes care of Medicare enrollees for half the cost of the average in the nation with top quality scores www.dartmouthatlas.org All of the health care value leaders network organizations are showing similar dramatic results.
What's happening at these organizations and a few others is a commitment to improve themselves using a methodology that is understandable and is proven. This methodology has not been widely accepted in the industry which is one reason why costs keep going up and quality doesn't improve.These organizations are committed to documenting and sharing this proven methodology on behalf of all the patients in America. In the Gundersen and ThedaCare cases alone if all health systems could achieve these results there would be more than a trillion dollars of savings in the next 10 years with hundreds of thousands of lives saved.
This Center and The Lean Enterprise Institute have formed a partnership to facilitate many networks of hospitals and doctors who want to learn this methodology and improve. Visit www.healthcarevalueleaders.org web site to sign up to become one of the learners of the proven methodology for reducing defects and improving patient outcomes.
In summary, with the political wrangling going on we must not lose site of the fact that we need essential payment reform which supports the innovation described above and we need all health care organizations to focus on learning how to remove waste, about a trillion dollars worth.
John S. Toussaint, MD
President and CEO, ThedaCare Center for Healthcare Value