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News / Business / Columnists

Brunell: Health care top of mind for Americans

By Don Brunell
Published: December 4, 2018, 6:00am

When Congress convenes next year, lawmakers must focus on the cost and quality of health care.

In November, voters made it clear that health care was on top of their minds. According to the Kaiser Family Foundation, a third of voters said it was the “most important” issue. It ranked higher than the economy and jobs.

What is driving Americans is their fear of losing health insurance, their home and savings to battle cancer or other life-threatening conditions.

According to The Washington Post, our country spent $3.4 trillion on health care in 2016, and that number is projected to jump to $5.5 trillion by 2025.

A study by the Centers for Medicare and Medicaid Services projects that the average growth in health spending will be even faster between 2016 and 2025, at 5.6 percent per year. The costs are driven by inflation in the cost of medical services and products and an aging population.

Those costs are hitting our budgets hard. According to the annual Milliman Medical Index, a typical family of four insured by the most common health plan offered by employers will average $28,166 this year. That’s up from 2010, when the costs crossed $20,000. Just two years ago, it topped $25,000, the Post added.

There are many reasons for the rising costs for health care.  Attempts to root out costs have been frustrating and difficult to achieve.

In an effort to bend the costs downward and improve the health care, Amazon’s Jeff Bezos, Omaha billionaire investor Warren Buffett and JPMorgan Chase CEO Jamie Dimon pooled their resources and hired Dr. Atul Gwande, a prominent surgeon and author, to lead the endeavor.

Gwande is a critic of America’s health care system and is viewed by some as a disrupter who is highly qualified. Robert Pearl, M.D., who writes for New Yorker Magazine, wrote: “I am continually amazed by the clarity of his vision, and his ability to change people’s actions by changing their perceptions.”

Checklists

In 2009, Gwande raised eyebrows in his book, “Checklist Manifesto,” in which he advocated checklists as a way to prevent costly medical mistakes resulting in litigation and patient death.

He traces the need for pre-flight checklists back to a B-17 test flight crash near Boeing Field in 1935. Investigators found that the pilot left an elevator lock on and the aircraft didn’t have enough lift to fly. The three crew members were seriously injured, and the B-17 became the first aircraft to get a checklist.

Gwande believes medical checklists are just as important as those airlines commonly use today. They are routine and highly effective in eliminating errors.

Medical errors have been chronic. In 2016, an eight-year study by researchers at Johns Hopkins University found that medical errors are the third-highest cause of death in our nation. They account for 10 percent of all U.S. deaths.

In the Johns Hopkins study, “the Center for Disease Control reported in 2013, 611,105 people died of heart disease, 584,881 died of cancer and 149,205 died of chronic respiratory disease — the top three causes of death in the U.S. The newly calculated figure for medical errors puts this cause of death behind cancer but ahead of respiratory disease.”

Gwande is focused on what he considers wasteful spending, which is estimated to be $765 billion a year — 25 percent of all U.S. health care spending.

Finally, he is looking to reform the way our system views end-of-life treatment. That is particularly important to our growing number of retired citizens.

So, stay tuned. Health care is the squeaky wheel needing fixing.

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