A Statistical Tour and Frame of the American Healthcare System Richard G. Wendel MD, MBA
Greater Cincinnati Healthcare Market <ul><li>31hospitals that employ over 53,000 and contributes more than $14 billion to the local economy annually </li></ul><ul><li>More than 15 public health/neighborhood centers serving low income patients </li></ul><ul><li>5,200 practicing physicians </li></ul><ul><li>One medical school; 12 nursing schools; 1 pharmacy school </li></ul><ul><li>TriHealth, Mercy Health Partners, Alliance </li></ul>
The American healthcare system offers quality healthcare to its citizens. But the system has been nagged by problems with skyrocketing costs, universal access and medical mistakes.
Americans pay roughly twice as much on healthcare as other developed nations. (about $2.2-2.4 trillion or 16.5% of GDP or $7,800 per person). During this recession, aside from growing governmental programs, the healthcare services sector has been the only expanding part of our economy. For a decade it has accounted for most of the job creation.
Does this high rate of healthcare spending produce better access to healthcare, exemplary outcomes, and a healthier population?
Is healthcare a right or a privilege? Primarily due to high costs, the number of uninsured has continued to grow (47 million, depending upon your criteria )
Non-Hispanic blacks make up half of the uninsured 79% of the uninsured are American citizens 30 percent earn more than the median U.S. family income 11% of all Cincinnatians uninsured and 19% age 18-64 who were uninsured at the time of the poll
Physician practices receive about 13 percent of health- care dollars; 50 percent are spent on office overhead
Medical Malpractice may be considered a part of administrative expense or cost of doing business. The actual insurance and litigation costs consume only 1% of health care dollars, but the attendant defensive medicine costs are estimated at 4-5 percent of the healthcare dollar.
Marketing direct to the consumer often consumes 35 percent of revenues. R&D averages 20 percent of revenues
Unnecessary Procedures Many marginal therapies make the news
The current figure for payroll deductions in the Obama plan.
A recent article in the New England Journal of Medicine showed that 70 percent of physicians favored a ‘public option.’
Variation in Medicare Spending: Some Regions Already Spend at Canadian Level Vast differences in practice patterns
Tertiary Care Secondary Care Primary Care Tertiary Care Secondary Care Primary Care UK and European Health Care System US Health Care System Comparison of Health Care Systems Robert Smith, MD, Milan Petrovic, MD, University of Cincinnati
Finally, what is a quality-adjusted life year (QALY) worth? Many consider treatments to be cost-effective if they cost less than $50,000 to $75,000, but payers routinely cover treatments that cost more than $100,000 per QALY. Preventative care and healthy lifestyles are much more cost/efficient and effective in health outcomes than treatment.
18 percent of lifetime healthcare costs are consumed in the final year of life. How do you address the dilemma of futile care and marginal therapies?
Many of these issuers will be further examined during the hospital tours and in the afternoon group sessions