- complex
- resistant to change, and
- extraordinarily inefficient.
The most important
source of information on this issue, the report that is serving as the baseline
on the current situation and from which the $750 billion shortfall figure is
derived, comes from the Institute of Medicine (IOM). The IOM report, “Best Care at Lower
Cost: The Path to Continuously Learning Health Care in America,” (September
6, 2012) lists three “imperatives” for change:
- The rising complexity of modern health care,
- Unsustainable cost increases, and
- Outcomes below the system’s potentials.
It is important to note
that the unsustainable costs are only one part of the problem as defined by the
IOM. In fact, the report indicates that
the most important need is to establish a “continuous learning system”
and “a culture of continuous improvement” in the health care system. The report
asserts that continuous learning is needed to assure that “the lessons from
research and each care experience are systematically captured, assessed, and
translated into reliable care.”
While the thrust of the
report is on the need for systemic improvements, it identifies the specifics of
the waste for 2009:
Some employers belong to groups such as the National
Association of Manufacturers, who have lobbyists to make their interests known
to Congress. But employers without such resources also have a responsibility to
make their best interests known by contacting their legislators. (You could
help by bringing the IOM report to the attention of your legislator, for
example). Consider and share your ideas on how and why out-of-control health
care costs affect all employers, regardless of the number of employees.
- unnecessary services $210 billion
- inefficient delivery services $130 billion
- excessive administrative costs $190 billion
- too high prices $105 billion
- missed prevention opportunities $55 billion
- fraud $75 billion
