Imagine a patient with a persistent cough. Her doctor will diagnose her with bronchitis and prescribe an antibiotic. If the cough worsens, he will diagnose her with pneumonia and prescribe an antiviral. If that doesn’t work, he’ll diagnose her with asthma, then sarcoid, and then fibrosis. But no treatment works. Your cough is getting worse.
The treatments don’t work because the problem isn’t in your lungs. She has acid reflux, which inflames her esophagus and makes her cough.
America is that patient. Our lingering, worsening symptom is rising health care and insurance costs, and Washington is our doctor. From the founding of Medicare and Medicaid in 1965 to the Affordable Care Act in 2010, in solving this challenge, Washington has looked for ways to get more Americans into health insurance, be it public or private.
The results of Washington’s repeated attempts to implement so-called “health reform” speak for themselves. Health expenditure per capita increased dramatically increased from USD 353 per person in 1970 to USD 11,582 per person in 2019. Have average family bonuses more than tripled far above wage growth since 1999. The cost of expenses has also increased for patients and has increased by 10 percent or more in recent years.
The reason for this error is simple. Much like our hypothetical patient’s doctor who kept focusing on her lungs, Washington is trying to treat our healthcare affordability crisis in the wrong place. Health insurance is just a transit tool for health spending. While expanding coverage can help make individual health expenditures more predictable, it cannot make health care more affordable.
Unfortunately the new administration Health care plans are just an extension of the failed approach of the past five decades. Proposals like a public option and lowering Medicare eligibility to age 60 will not make health care more affordable as they will focus on insurance, not health care. This tired, insurance-centric approach is likely to fall within the same party-political battle lines that have defined the healthcare affordability debate for two decades.
It is time for a new treatment plan for American health care problems that will pinpoint the root cause of the problem and where both parties can join forces. It is not the lack of coverage that leads to an increase in healthcare costs. Instead, it is high health prices and high demand for health services. There is no way to make healthcare affordable without reducing both. Here are three strategies for making healthcare more affordable that President Biden and a tightly-knit Congress should agree on.
First, we need to fix the broken health goods and services market that has led to price increases that have spiraled out of control. The track record of the past 50 years shows that third party health insurers are at best unable to control health prices. In the worst case, they contribute to price escalation. We also know that the introduction of price controls by governments creates scarcity. Neither out of control prices nor rationing are acceptable for our healthcare.
Instead, we need to consider what works in every other market to lower prices, increase quality, and expand options: individual customers (in this case, patients) make informed decisions between providers who are given the freedom to innovate . Research shows that 70 percent of inpatient and 90 percent of outpatient services are shopping. Reforms that give patients better visibility of price and quality, as well as real incentives to respond to this information and removing barriers that make it difficult for doctors to practice medicine, are the only ways to really get choice and competition in healthcare to reduce prices. President TrumpDonald TrumpSchumer: The impeachment proceedings will be quick and won’t need many witnesses Nurse to be tapped by Biden as acting general surgeon: report Schumer calls on Biden to explain the climate emergency MOREThe pricing transparency rules for hospitals and providers were a strong first step. Democrats and Republicans should be able to unite in reforms that reinforce and build on this rule. Polls show This price transparency in healthcare is preferred by 90 percent of Americans.
Second, we need to reduce chronic illnesses in America. These largely avoidable conditions Account for 75 percent of all health care expenditure and most doctor visits, prescriptions, family doctor visits and inpatient stays. We can start reforms to prioritize preventive medicine and high quality primary care. Our largely acute care system is very good at keeping you alive, but not very good at keeping you healthy.
Chronic diseases, however, are both a cultural and clinical challenge. Research shows that 80 percent of health outcomes are due to factors in front of the doctor’s office. Changing the cultural and societal patterns that lead to chronic illnesses require decades of society-wide efforts. We should learn lessons from our success in reducing smoking to other lifestyle risk factors for chronic illness in order to build a culture of healthy longevity in America. The disproportionate impact of COVID-19 on those with underlying health problems once again paid attention to America’s poor health. Republicans and Democrats should be able to unite on a plan to “make America healthy again.”
The third strategy is to accelerate scientific and technological advances in healthcare by increasing public and private investment in research and development and optimizing the path from laboratory to patient. The genetic revolution promises cures for hereditary diseases that would otherwise lead to decades of expensive treatments. There is new scientific knowledge about the underlying biological aging process that could extend our healthy years of life and make us much more resilient to age-related diseases. In addition, technologies like healthcare wearables, telemedicine, home health kits, and artificial intelligence offer people more options for care and can lower prices. New treatments and a renewed focus on prevention could one day eradicate chronic diseases in America.
Empowering patients and physicians to lower prices and improve quality; Focus on reducing chronic disease in the clinic and in culture; These three approaches are very different from the typical Washington approach to “health reform”. They invest heavily in scientific research and remove bureaucratic barriers to accelerate the availability of new treatments and technologies in healthcare. But only when we focus on the real causes of rising health care costs can the disease be cured.
Joe DeSantis is the Chief Strategy Officer at Gingrich 360 and leads the Bettercare project. Follow him on Twitter @joedesantis.