Cut Health Care Costs – Not Benefits

In the summer of 1968 I was working on the final few college credits I needed for a degree in mathematics and looking forward to a vacation with my wife and two-year old daughter.  Then one of my professors gave the class an impossible assignment; write a paper on an “original” mathematical theory.

I was floored.  How could I “invent” a mathematical concept from scratch?  But after considerable anger, punctuated with copious expletives, I tried to think outside the box.   My paper would describe how complex mathematical equations could be solved by a computer, sort of nascent artificial intelligence.  I had no idea how it would be received, but a B+ helped me pass the course.

Well, I believe researchers must think outside the box to deliver more effective health care at lower cost.  And artificial intelligence (AI) could greatly facilitate that effort.

Why is automation the number one eliminator of manufacturing jobs in the U.S.?  It reduces costs. But while U.S. manufacturers are making cheaper products to meet competition, health care gets more expensive every year, in part because there is less automation and little competition.

Computer power and AI have come a long way since the 1960s.  Initially smart technology in appliances like rice cookers was called “fuzzy logic” to dumb it down for the public.  Now it pervades our daily lives — but more is needed in medical facilities.

During my recent physical exam, a nurse practitioner – we need more of them too — discussed my medications, listened to my heart and lungs and ordered my yearly blood tests.  Why couldn’t an AI machine listen to my organs and assess how they are functioning?  I’ll bet the result would be as good as most specialists.  A smart phone or similar device could be used as a stethoscope at rural medical facilities and the signals transmitted to a central computer hundreds-of-miles away for analysis.

I have no doubt that a robot could take my blood sample and provide better information than a printed report that only shows if my blood chemicals are within healthy parameters.  And what if there was a computer database that contained blood analyses from patients all over the country, along with their medications and clinical history?  Could AI use such a resource for early detection of cancer, diabetes and other diseases?  I think so; and the result would be lower treatment costs and better medical outcomes.

The United States has the most expensive health care system among developed nations, with total costs exceeding $3.3 trillion in 2016 and administrative costs estimated to exceed $300 billion.  Yet Americans don’t use more health care than other countries or have better health.

Filling out four pages of forms every time I see a new physician frustrates me.  Paper shuffling doesn’t improve health care.  It just means more wasted effort and expense when my information could be maintained in a national database.  Does the doctor ever look at it, much less try to evaluate it?   Some are too busy seeing 50 or more patients every day.  One physician I considered had 85 patients on his daily schedule.

What if Medicare and Medicaid maintained a database on every beneficiary that included medical history, medications taken and historical blood test results?  I’ll bet it would result in more effective and less expensive health care.  Yes, there are privacy issues, but those can be handled.

Actually, a similar project called the Precision Medicine Initiative was started under President Obama’s administration by the National Institute of Health.  The NIH is assembling genomic information from a million volunteers for the world’s largest genetic library. It will be widely available to scientists and researchers in hopes of making faster advances in gene-based medicine.

Data like this is the raw material for dramatic medical discoveries.

But instead of greatly increased investments in medical science and other health care technology, most Republicans and many Democrats keep throwing money at the military. The Congressional Budget Office projects that defense will cost almost $7 trillion over the next decade.  This will exceed the discretionary spending for all other government functions.  And Republicans want further reductions in nondefense spending.

Republicans also favor turning government functions over to private industry.   But let’s face it, corporations are focused on making profits; they don’t give a damn if Americans have to pay more for health care.  In fact, some gain from it.  And many in Congress don’t care either so long as they can get reelected.

Medicare and Medicaid are two of the most expensive items in the federal budget and these programs simply aren’t sustainable long term with costs going up every year.  But Speaker Paul Ryan (R-Wis.) and his colleagues in Congress have only one solution in mind — turn Medicare into a premium support system and reduce funding for Medicaid.  These GOP plans would cut health care benefits for millions of Americans and I don’t think they are politically viable.

Health care is critical for everyone, regardless of political party.   Voters need to be like my math professor and give politicians an impossible assignment; provide better health care at lower cost or you won’t graduate to another term.  Only then will legislators start thinking outside the box and find a way to get it done.

 

About eeldav

I am a retired corporate attorney who has lived in both Europe and Asia. While working my responsibilities took me to over 40 countries in Europe, the Middle East, Africa and Asia.
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3 Responses to Cut Health Care Costs – Not Benefits

  1. A welcome shift of topic focus away from trump and his follies. Thanks
    Part of the medical cost driver is the legal profession and malpractice litigation i believe. Placing some caps or limits on damage recoveries would reduce the cost of malpractice insurance and so (one assumes) reduce the cost of health care.

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  2. Greyfox76 says:

    The possibilities for improving health care costs and quality of delivery are most numerous. The POS (Point of Service) concept of billing is ridiculous. Every band-aid and Que-tip is separately tracked and charged for. Nonsense. I should be able to show up at a hospital for cataract surgery, or whatever, and have a fixed price deal based upon the average costs of such procedures in that hospital. As well, the record of outcomes for these procedures should be known by the hospital and made public so all can evaluate the delivered quality of care. The number and disposition of complaints(law suits) at that hospital should be public info. Tort reform to reduce or eliminate “no recovery-no pay” law suits is essential. Laws to make attorneys who bring frivolous law suits pay penalties to defendants would be an advancement. The Congress must allow governmental agencies such as medicare/medicaid to negotiate drug prices and allow individuals to purchase quality drugs internationally for lower costs.The Veterans Administration can be disbanded by simply giving all entitled vets a health care card usable at the health care provider of their choice, etc., etc., etc.

    The real challenge here is how to separate those who benefit from the imperfections of the current system from process improvements which we all know would help greatly. It’s the same with politicians. They benefit from the current corruption and unethical practices which are now tolerated, but most of the existing incumbents would welcome changes. The number of experienced legislators choosing not to run for re-election is testimony to their frustration with the current situation.

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  3. Michael Arrowood says:

    A welcome article! There are so many archaic things about U.S. medical delivery, it would be comical were it not tragic (and expensive). I share your frustration with endless paperwork to fill out before each doctor visit. There’s little sharing of information, even within the same system (Pardee Urgent Care and UNC Pardee Hospital cannot share records, for example). Some doctors opt out of the system through which they could access resources. Others still use faxing (!) almost exclusively to communicate, and can’t be reached via email. I could go on and on… that’s just the tip of the iceberg. Don’t get me started on inscrutable healthcare billilng and customer service. I like the idea that Amazon and its partners put forward this week, of creating a new not-for-profit healthcare system for their employees that will take a lot of the inefficiency and mystery out of how we get medical services. I see that sent a chill through insurance and pharmaceutical stocks on Wall Street – so maybe it’s a step in the right direction.

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