Preventing the 'Triple Fail'
By Phil Colpas, Editor, May 2013
Most of us by now have heard of the so-called “Triple Aim,” the term used to describe the three-pronged goal of worldwide healthcare: better health and better care at lower cost. The April issue of Health Affairs, a leading journal of health policy thought and research, explores the possibilities of a “Triple Fail” among high-income countries, especially the United States. In other words, worse health and worse care at higher cost.
And it’s not difficult to see how this worst-case scenario could become reality.
Health: A recent study by the International Association for the Study of Obesity (IASO) states there are more overweight and obese people around the world than the entire population of China (which, by the way, is more than 1.3 billion people).
Care: Nearly half of all working-age U.S. adults went without health insurance for an extended period of time last year or had out-of-pocket costs that were so high relative to their income they were considered underinsured, according to the Commonwealth Fund 2012 Biennial Health Insurance Survey.
Cost: A Health Affairs study, by Panos Kanavos of the London School of Economics and Political Science and coauthors, states drug prices in the United States were between 5 percent and nearly 200 percent higher than in the other nations studied. “A key contributing factor is that the United States takes up use of new and more expensive prescription drugs faster than other countries,” the article states. The authors recommend that the U.S. institute new procedures that would require pharmaceutical manufacturers to provide more evidence about the value of new drugs in relation to the cost before use of such drugs is reimbursed. (And – just a thought – but wouldn’t this also reduce the number of lawsuits?)
No matter your political ideology, one thing is very clear: The healthcare system in this country is beyond broken. Take, for example, the average individual working a full-time job with health insurance partially covered by his or her employer. Even if the employer is paying half the premium, it is likely the employee is paying about $300 a month just for coverage; doctors’ appointments, procedures, medication all are extra. If the job is lost, most cannot afford Cobra coverage, even for a brief period of time. An individual policy is likely not an option either, because it’s cost-prohibitive, or the applicant will be refused because of pre-existing conditions. (The latter will supposedly cease to become an issue in January 2014, but we have yet to see what costs will be.)
The optimistic view is that the Hippocratic Oath will eventually trump greed.
Where does healthcare IT fit into this ugly puzzle? By bringing costs down and – hopefully – eventually passing that savings on to the consumer. For now, we have to wait and see how healthcare reform plays out. So stay tuned – and keep your fingers crossed.