As the U.S. continues to debate solutions to the problem of rising health care costs, TEDMED facilitated a live discussion about some possible answers with industry experts Thursday.
Kavita Patel, M.D., former director of policy for the Office of Intergovernmental Affairs and Public Engagement for the White House, moderated the hour-long installment of TED’s Great Challenges program. The event streamed via YouTube.
Patel began by offering these statistics: ”In 1980, we had health care expenditures of $256 billion. In 2010, thirty years later, our health care expenditures were $2.6 trillion.” She then asked if the national health care system would benefit from physicians receiving standard reimbursements instead of fee-for-service payment.
Chapin White, a researcher for the Center for Studying Health System Change, provided an answer most doctors won’t like. “I think bringing physicians’ salaries down would certainly reduce health care spending,” White said, though noting that salaries are a small slice of overall costs.
Jeanne Stamper, a program director for Xerox Services, said we should be thinking more broadly.
“We see the trend now where a lot of physicians are giving up their private practices and going to work for these larger organizations,” Stamper explained. “So there’s a lot of change in the landscape of who’s getting paid.”
Anne Gauthier, senior program director at the National Academy for State Health Policy, said some physicians may rationalize more care to patients- regardless of that care’s usefulness.
“Physicians may have an incentive to repeat tests or to get their own information because it is not in one central place,” Gauthier explained.
“I think that we are deeply acculturated to ‘more is better.’ More medical care is necessarily better, and those who have studied this know this is not true.”
To view more in-depth analysis of this issue, some participants contributed written responses to questions from those who watched online.
For example, one TED community member asked how both doctors and patients could come to understand that doing less is often the best medicine.
Ron Pollack, J.D., executive director for Families U.S.A., answered by highlighting estimates that one-third of care delivered in the U.S. does nothing to improve outcomes and may actually be harmful.
“Without a doubt, there is a great deal of overuse and misuse within our system,” Pollack wrote. He also emphasized the need to learn more about what the right care really is.
Stamper responded similarly, pointing to care at the end of life. “Often medical decisions conflict with the patient and family’s values – I want to die at home, I want to spend as much time with family as possible, I want to keep my loved one alive as long as possible.”
Overall, the experts agreed that an American cultural shift must begin towards discussing health care costs and the end of life sooner.
“I think that we are deeply acculturated to ‘more is better’,” Gauthier offered. “More medical care is necessarily better, and those who have studied this know this is not true.”
Learn more from the Life Matters Media Newswire:
The lack of advance care planning persists
“Consider the Conversation”: A discussion at Fourth Presbyterian Church