Improving the Nation’s Health with More Efficient Care

Professor Carl J. Schramm wrote about Improving the Nation’s Health with More Efficient Care as part of a GE Ideas Roundtable that included two good interactive infographics about working in America and how different nations view innovation. But I don’t think improving the efficiency of care is where the biggest benefits lie, so I added this comment:

Technology can be a two-edge sword. On one hand it has contributed to the doubling of the amount of published medical information every year or two, causing general practitioners to specialize just to keep up with changes in their field. On the other hand, innovations such as telehealth, remote monitoring and analysis of medical & environmental sensors, and IBM’s Watson supercomputer applied to medical diagnostics, will help to move many procedures and tests down-market from MD to PA, NP, RN, aid and consumers in their homes.

But aren’t we still addressing the wrong problem? It’s not so much about the efficiency of delivering care but eliminating the need for it. We currently have a “sick care” system, not a health care system, and that’s the real problem to focus on. When patients are viewed as customers of the health care system, practitioners and institutions have financial incentives to keep them as patients – i.e. treat symptoms rather than provide cures or prevent illness in the first place. Even health insurance providers fuel this backwards view, since more demand for medical care leads to higher premiums and larger profits.

Some of the most effective progress in health care has come from public health programs such as immunization, clean water, and education about smoking, nutrition, and exercise. I’d throw poverty and obesity into that mix since, according to HBO’s documentary The Weight of the Nation, public health officials can reliably predict a community’s average weight by zip code and have noticed lifespan differences of more than 20 years between poor neighborhoods on one side of town and affluent ones on the other side just 8 miles away.

As always, if you don’t agree or have another perspective to share, please comment below.