What’s Driving         Health Care Costs?        Universal, Affordable Care for               Massachusettshttp://masscare...
U.S. Spends Almost Double Next   Highest Spending Country
Common Explanations for        High Health Care Costs•   Inadequate Prevention                  •   Fee-for-service: overu...
Common Explanations for        High Health Care Costs•   Inadequate Prevention                  •   Fee-for-service: overu...
Common Explanations for        High Health Care Costs•   Inadequate Prevention                  •   Fee-for-service: overu...
Common Explanations for        High Health Care Costs•   Inadequate Prevention                  •   Fee-for-service: overu...
Disease Prevalence:                U.S. vs. Peer Countries                        Other                                   ...
Disease Prevalence:                U.S. vs. Peer Countries                        Other                                   ...
Physician Visits Per Capita, 200914                                        13.21210                                    8.2...
Hospital Stays per 1,000                population, 2009300                             263250                            ...
Average Length of Hospital Stay in               Days, 200998               7.7         7.5                           7.57...
Nations With UniversalHealth Care Coverage
How Universal Health    Care Is Paid For      Fixed Payroll Tax                Negotiated Budget                          ...
How U.S. Health Care          Is Paid For                  Medicaid      Taxes       Medicare                             ...
Insurance Administration CostsOECD Data, 2010
Hospital Administration CostsOECD, 2010
Aortic Aneurysm Repair CostsBrox. et. al. Arch Internal Medicine, 2003
U.S. Pays Higher Prices for             the Same Drugsmt.gov.com, 2010
Training: What's Driving Health Care Costs?
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Training: What's Driving Health Care Costs?

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Training: What's Driving Health Care Costs?

  1. 1. What’s Driving Health Care Costs? Universal, Affordable Care for Massachusettshttp://masscare.org
  2. 2. U.S. Spends Almost Double Next Highest Spending Country
  3. 3. Common Explanations for High Health Care Costs• Inadequate Prevention • Fee-for-service: overuse of tests and• Behavioral factors procedures – High obesity rate • Lower cost transparency – High smoking rate • More third party insurance payers – High levels of drinking • More physician visits• Racial and Ethnic Makeup of the U.S. • More ER and hospitals visits• Aging population • More Medical Malpractice lawsuits• End of life care • Worse electronic health records• Chronic Illnesses • Higher Cost of drugs – High cancer rates • Higher cost of medical devices – High diabetes rates • Too much hospital bargaining power – High heart disease rates • More profits• Overuse of technology (e.g. MRIs, CT • More administration/paperwork scans, etc) • Higher physician/nurse pay• Use more prescription drugs
  4. 4. Common Explanations for High Health Care Costs• Inadequate Prevention • Fee-for-service: overuse of tests and• Behavioral factors procedures – High obesity rate • Lower cost transparency – High smoking rate • More third party insurance payers – High levels of drinking • More physician visits• Racial and Ethnic Makeup of the U.S. • More ER and hospitals visits• Aging population • More Medical Malpractice lawsuits• End of life care • Worse electronic health records• Chronic Illnesses • Higher Cost of drugs – High cancer rates • Higher cost of medical devices – High diabetes rates • Too much hospital bargaining power – High heart disease rates • More profits• Overuse of technology (e.g. MRIs, CT • More administration/paperwork scans, etc) • Higher physician/nurse pay• Use more prescription drugs
  5. 5. Common Explanations for High Health Care Costs• Inadequate Prevention • Fee-for-service: overuse of tests and• Behavioral factors procedures – High obesity rate • Lower cost transparency – High smoking rate • More third party insurance payers – High levels of drinking • More physician visits• Racial and Ethnic Makeup of the U.S. • More ER and hospitals visits• Aging population • More Medical Malpractice lawsuits• End of life care • Worse electronic health records• Chronic Illnesses • Higher Cost of drugs – High cancer rates • Higher cost of medical devices – High diabetes rates • Too much hospital bargaining power – High heart disease rates • More profits• Overuse of technology (e.g. MRIs, CT • More administration/paperwork scans, etc) • Higher physician/nurse pay• Use more prescription drugs
  6. 6. Common Explanations for High Health Care Costs• Inadequate Prevention • Fee-for-service: overuse of tests and• Behavioral factors procedures – High obesity rate • Lower cost transparency – High smoking rate • More third party insurance payers – High levels of drinking • More physician visits• Racial and Ethnic Makeup of the U.S. • More ER and hospitals visits• Aging population • More Medical Malpractice lawsuits• End of life care • Worse electronic health records• Chronic Illnesses • Higher cost of drugs – High cancer rates • Higher cost of medical devices – High diabetes rates • Too much hospital bargaining power – High heart disease rates • More profits• Overuse of technology (e.g. MRIs, CT • More administration/paperwork scans, etc) • Higher physician/nurse pay• Use more prescription drugs
  7. 7. Disease Prevalence: U.S. vs. Peer Countries Other 97% Back problems 91%Osteoarthritis/joint disorders 86% Diabetes melitus 122% Hypertension 77% COPD, asthma 67% Mental disorders 98% Cancer 105% Trauma-related disorders 106% Heart conditions 95% 0% 20% 40% 60% 80% 100% 120% 140%
  8. 8. Disease Prevalence: U.S. vs. Peer Countries Other 97% Back problems 91%Osteoarthritis/joint disorders 86% Disease Diabetes melitus 122% prevalence Hypertension 77% = $57 to $70 COPD, asthma 67% billion savings Mental disorders 98% Cancer 105% Trauma-related disorders 106% Heart conditions 95% 0% 20% 40% 60% 80% 100% 120% 140%
  9. 9. Physician Visits Per Capita, 200914 13.21210 8.2 8 6.9 6.5 6 5.5 5.7 5 4.6 4.3 4 4 2.7 2.9 2 0
  10. 10. Hospital Stays per 1,000 population, 2009300 263250 237200 170 177 162 166 168150 142 138 131 117100 8450 0
  11. 11. Average Length of Hospital Stay in Days, 200998 7.7 7.5 7.57 6.8 5.9 5.96 5.4 5.6 5.25 4.6 4.543210
  12. 12. Nations With UniversalHealth Care Coverage
  13. 13. How Universal Health Care Is Paid For Fixed Payroll Tax Negotiated Budget Government Health CareYou Fund Providers
  14. 14. How U.S. Health Care Is Paid For Medicaid Taxes Medicare Separate contracts Blue Cross Premiums Tufts Medical InsuranceYou Out-of-Pocket Costs Health Care Providers
  15. 15. Insurance Administration CostsOECD Data, 2010
  16. 16. Hospital Administration CostsOECD, 2010
  17. 17. Aortic Aneurysm Repair CostsBrox. et. al. Arch Internal Medicine, 2003
  18. 18. U.S. Pays Higher Prices for the Same Drugsmt.gov.com, 2010

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