Those following the debate over healthcare reform often hear that eliminating waste from the current healthcare system would, in large measure, fund reform. Given the number of dollars wasted, the lives lost and the suffering associated with sloppy healthcare, why do we drag our feet in improving our current system and reducing waste?
A report released 10/26/09 by Thomson Reuters, parent company of the Reuters news service, stated that the current U.S. health system wastes between $505 billion and $800 billion a year, one-third of our current healthcare expenditure. The report cites the following as sources of wasteful spending:
- Overuse of antibiotics and lab tests to protect against malpractice lawsuits (Pennsylvania State University estimates that as much as 91 percent of our nation’s healthcare expenditures are related to defensive medicine);
- Fraud, which may be as high as $200 billion annually in Medicare claims alone;
- Administrative inefficiency and redundant paperwork;
- Medical mistakes;
- Preventable conditions, such as uncontrolled diabetes.
The report states that the average U.S. hospital spends one-fourth of its budget on billing and administration (twice what is spent in Canada). Eight hours per week and 1.66 clerical staff, on average, are needed for each doctor, again far more than is the case in Canada.
On 10/22/09 Health and Human Services Secretary Kathleen Sebelius announced a $17-million initiative to address HAI or hospital-acquired infections. Thanks to concerned citizens, such as former Lt. Gov. Betsy McCaughey of New York, whose Committee to Reduce Infection Deaths was established in 2004, attention has been drawn to the fact that there are 2 million cases of HAI each year, resulting in 100,000 deaths and an additional $33 billion in healthcare costs (www.hospitalinfection.org). That is a true national emergency requiring immediate action, so why doesn’t every U.S. hospital adopt the proven techniques developed by the Committee to Reduce Infection Deaths? President Bush’s administration took a huge step forward by stating Medicare would no longer pay for the costs of hospital-acquired infections. Let’s enforce this immediately.
Hannah Wunsch, M.D., of Columbia University Medical Center compared 493,054 patients in the United Kingdom with 704,028 patients from seven U.S. states, all of whom died in 2001. Roughly half of all U.S. hospital deaths involved ICU care, whereas only one in 10 of the British patients had received ICU care prior to dying. As Wunsch said, “What do we get with all the intensive care we’re giving people?” And Wunsch is an intensive-care doctor!