COL CHUCK WILLIAMS DIRECTOR TAO-EA
Sustainable Healthcare in US?
Drivers of Health Care Spending Growth <ul><li>Over the last 4 decades, health care spending growth has been driven by: </...
Growth in National Health Care Spending:  as % of GDP
What Do We Get For It? U.S. Ranking In Health <ul><li>By any measure, U.S. spends more on health care than any other natio...
HOW THE US STACKS UP: PREVENTABLE DEATHS <ul><li>1.  France  -- 65 </li></ul><ul><li>2. Japan -- 71 </li></ul><ul><li>3. A...
Healthcare Costs: How About An Inter/Intra State Comparison <ul><li>Health care is not practiced the same way across the c...
Healthcare Costs  (Contd.) <ul><li>In high-cost places, on average: </li></ul><ul><ul><li>Doctors order more frequent test...
Healthcare Costs  (Contd.) <ul><li>To make matters worse </li></ul><ul><li>High-cost communities appear to practice the lo...
The “Status Quo” is Not an Option <ul><li>Large/growing structural deficits due to demographic trends and rising health ca...
Stay hopeful… Go invent the future.
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Sustainable Healthcare

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Link to current Sustainable Healthcare discussion. Summary of factors affecting healthcare costs. Conclusion: status quo untenable. No prescriptive solutions...need to invent future. Sourced from presentation by Colonel Chuck Williams, EURASIA TRICARE Area Office.

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Sustainable Healthcare

  1. 1. COL CHUCK WILLIAMS DIRECTOR TAO-EA
  2. 2. Sustainable Healthcare in US?
  3. 3. Drivers of Health Care Spending Growth <ul><li>Over the last 4 decades, health care spending growth has been driven by: </li></ul><ul><ul><li>population growth </li></ul></ul><ul><ul><li>increase in health insurance coverage </li></ul></ul><ul><ul><li>medical inflation, and </li></ul></ul><ul><ul><li>increased utilization of services: </li></ul></ul><ul><ul><ul><li>growth in the number of services (volume) and </li></ul></ul></ul><ul><ul><ul><li>the complexity of these services (intensity) </li></ul></ul></ul>Presentation for the Task Force on the Future of Military Health Care – 18 Apr 2007 U.S. Comptroller General
  4. 4. Growth in National Health Care Spending: as % of GDP
  5. 5. What Do We Get For It? U.S. Ranking In Health <ul><li>By any measure, U.S. spends more on health care than any other nation </li></ul><ul><li>In 2010 ranked 49th in life expectancy </li></ul><ul><li>13 industrialized nations 1975-2005: </li></ul><ul><ul><li>Life expectancy & health care costs increased </li></ul></ul><ul><ul><li>U.S. had lowest increase in life expectancy/highest increase in costs </li></ul></ul>Nicholas Bakalar Nov 29, 2010 CIA World Fact Book WHO data 1975-2005
  6. 6. HOW THE US STACKS UP: PREVENTABLE DEATHS <ul><li>1. France -- 65 </li></ul><ul><li>2. Japan -- 71 </li></ul><ul><li>3. Australia -- 71 </li></ul><ul><li>4. Spain -- 74 </li></ul><ul><li>5. Italy -- 74 </li></ul><ul><li>6. Canada -- 77 </li></ul><ul><li>7. Norway -- 80 </li></ul><ul><li>8. Netherlands -- 82 </li></ul><ul><li>9. Sweden -- 82 </li></ul><ul><li>10. Greece --84 </li></ul><ul><li>11. Austria -- 84 </li></ul><ul><li>12. Germany -- 90 </li></ul><ul><li>13. Finland -- 93 </li></ul><ul><li>14. New Zealand -- 96 </li></ul><ul><li>15. Denmark -- 101 </li></ul><ul><li>16. UK -- 103 </li></ul><ul><li>17. Ireland --103 </li></ul><ul><li>18. Portugal --104 </li></ul><ul><li>19. US -- 110 </li></ul>The U.S. ranks at the bottom of 19 industrialized nations in the number of preventable deaths by conditions such as diabetes, epilepsy, stroke, influenza, ulcers, pneumonia, infant mortality and appendicitis. The number at the right represents the number of preventable deaths per 100,000 population in each country in 2002-2003. Source: Commonwealth Fund, Health Affairs, World Health Organization In 1997-1998, the United States ranked 15th
  7. 7. Healthcare Costs: How About An Inter/Intra State Comparison <ul><li>Health care is not practiced the same way across the country </li></ul><ul><li>Annual Medicare spending varies by more than double </li></ul><ul><ul><li><$6,000 per person in some cities to more than $12,000 per person in others </li></ul></ul><ul><li>“ Visited a place recently where Medicare spends more on health care than the average person earns” </li></ul><ul><li>As you look between cities of similar circumstances —between places like McAllen and El Paso, Texas, just a few hundred miles apart—you will still find up to two-fold cost differences </li></ul><ul><li>Even within cities , Medicare’s costs for patients of identical life expectancy differ by as much as double , depending on which hospital and physicians they go to </li></ul>June 12, 2009 Atul Gawande: Univ of Chicago Medical School Commencement Address The New Yorker June 12, 2009
  8. 8. Healthcare Costs (Contd.) <ul><li>In high-cost places, on average: </li></ul><ul><ul><li>Doctors order more frequent tests </li></ul></ul><ul><ul><li>And procedures, </li></ul></ul><ul><ul><li>More specialist visits, </li></ul></ul><ul><ul><li>More hospital admissions </li></ul></ul><ul><li>BUT…patients do no better , whether measured in: </li></ul><ul><ul><li>Survival, </li></ul></ul><ul><ul><li>Ability to function, or </li></ul></ul><ul><ul><li>Satisfaction with care </li></ul></ul><ul><li>If anything, they seemed to do worse! </li></ul>June 12, 2009 Atul Gawande: Univ of Chicago Medical School Commencement Address The New Yorker June 12, 2009
  9. 9. Healthcare Costs (Contd.) <ul><li>To make matters worse </li></ul><ul><li>High-cost communities appear to practice the low-cost, low-profit approaches: </li></ul><ul><ul><li>Providing preventive-care measures, </li></ul></ul><ul><ul><li>Hospice for the dying, and </li></ul></ul><ul><ul><li>Ready access to a primary-care doctor </li></ul></ul><ul><li>“ Patients get more stuff, BUT </li></ul><ul><li>not necessarily more of what they need” </li></ul>“ Less” consistently for their patients June 12, 2009 Atul Gawande: Univ of Chicago Medical School Commencement Address The New Yorker June 12, 2009
  10. 10. The “Status Quo” is Not an Option <ul><li>Large/growing structural deficits due to demographic trends and rising health care costs </li></ul><ul><li>GAO’s simulations show that balancing the budget by 2040 could require actions as large as: </li></ul><ul><ul><li>Cutting total federal spending by 60 percent or </li></ul></ul><ul><ul><li>Raising federal taxes to 2 times today's level </li></ul></ul><ul><li>Faster Economic Growth Can Help, but It Cannot Solve the Problem: </li></ul><ul><ul><li>Would require real average annual economic growth in double digit range every year for next 75 years! </li></ul></ul><ul><ul><li>As a result, we cannot simply grow our way out of this problem </li></ul></ul><ul><ul><li>“ Tough choices will be required” </li></ul></ul>Presentation for the Task Force on the Future of Military Health Care – 18 Apr 2007 U.S. Comptroller General
  11. 11. Stay hopeful… Go invent the future.

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