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New Study: Aging Baby Boomers Could Overwhelm U.S. Health Care System By 2017, Unless Decisive Action Is Taken
The approaching onslaught of over 70
million aging baby boomers could overwhelm the U.S. health care system and
engulf the nation's tenuous economy, according to a new study, "Will the
Boom Bust Health Care?," by management consulting firm Tefen USA.
A recent report from the Centers for Medicare and Medicaid Services
(CMS) predicts that unless decisive action is taken, total U.S. health care
spending will double to just over $4.3 trillion by 2017 - or nearly 20
percent of the nation's gross domestic product. Tefen USA estimates that
this figure could be considerably higher, based on its assessment of data
that people over the age of 65 experience nearly three times as many
hospital days per thousand as the general population, and that sixty-two
percent of 50-64 year-olds report having at least one of six chronic health
conditions: arthritis, high cholesterol, cancer, diabetes, heart disease
and hypertension.
Declining Hospital Capacity
Compounding the problem, according to Tefen, is a sharp decline in
hospital capacity. The number of community hospitals decreased from 5,384
to 4,915 between 1990 and 2000. During the same time period, the number of
beds per 1,000 of population decreased from 4.2 to 3.0. This reduction in
capacity, Tefen points out, has been accompanied by a sharp increase in
hospital staffing. Between 1995 and 2000, full-time equivalent personnel
increased from about 3,420,000 to about 3,911,400. At the same time,
hospitals have spent almost $100 billion in facility and infrastructure
improvements.
"There is an immense, growing disconnect within the U.S. health care
sector," said Barry Calogero, president, Tefen USA, and author of the
study. "Capacity is shrinking, costs are skyrocketing, and the patient
population is about to explode. Our nation must bring these disparate
factors into alignment in order to preserve the foundation of U.S. health
care while adapting to the economic, medical and political conditions of
today and tomorrow.
Severe Consequences Projected
As baby boomer-induced health care costs grow, these severe
consequences are likely to occur, according to the Tefen study:
-- The problem of uninsured Americans will escalate, as employers seek to
reduce the burden of retiree health care coverage, trim their
contributions to health care premiums and, in some instances, eliminate
the health care benefit entirely.
-- Health care quality will suffer, with wide variation in treatments and
big differences in death rates and surgical complications.
-- Federal spending on Medicare and Medicaid will skyrocket, forcing
politicians to raise taxes or severely curtail a wide range of other
government programs.
-- State budgets will suffer under the crush of soaring Medicaid costs,
compromising support for education and other local initiatives.
-- The nation as a whole will have fewer and fewer dollars to spend on
education, environmental protection, scientific research and national
security.
"Despite what many people think, the solution is not a single-payer
system," said Calogero. "While socialized medicine provides some advantages
from an access standpoint, it does not address the underlying cost and
quality issues that threaten the functional integrity of health care in the
U.S. The real solution to America's health care challenges requires three
components: implementing tort reforms, mandating the use of best practices
and driving systemic process improvement." The Tefen study provides
insights and details on each of these three solution elements.
Implement Tort Reforms
The study's author suggests that the threat of lawsuits causes
providers to hide problems and engage in unnecessary procedures to avoid
potential negative occurrences. "If caregivers document mistakes, they are
immediately exposed to litigation," observes Calogero. "Consequently,
obfuscation and secrecy become the standard practice when confronted with
errors. Quality issues are concealed and knowledge is suppressed, leading
to the high likelihood that mistakes will be replicated."
The solution, according to Tefen, is a system of health courts similar
in practice to the arbitration system utilized to address other complex
issues requiring dispute resolution, such as workers' compensation, tax and
patent disputes and vaccine liability, where claims against institutions
are adjudicated. Health courts would administer peer reviews and
independent analysis of procedural errors - differentiating between human
error and negligence - and determining damages proportionate to the
mistakes.
Mandate the Use of Best Practices
The current system of medical reimbursement actually rewards providers
for delivering more care - not necessarily better care, according to Tefen.
"With fairly uniform medical pricing across the industry set by the
government and private insurers, providers can optimize revenues only by
increasing the number of procedures," explains Calogero. "This perverse
system creates immense variability in how care is delivered. It gives
hospitals and doctors little incentive to consistently provide treatments
that medical research has shown produce the best results."
The solution, according to Tefen, is a mandated system that holds
providers accountable for delivering health care using the best known
practices and protocols. Such a system would reduce variability and
administer compensation directly tied to improving practice patterns and
medical outcomes.
Drive Systemic Process Improvement
When compared to other industries, health care is the single largest
sub- optimized sector of the U.S. economy, states the author. Rampant
opportunities exist to transform inefficient, serial processes into
efficient, parallel ones that eliminate unnecessary activities in the care
giving process. As an example, Calogero cites a study at a major academic
medical center which found that only 25 percent of nurses' time was spent
actually providing care in a patient's room. The rest was consumed with
administrative chores.
The solution, according to Tefen, is to change inefficient paradigms.
"By removing redundant duties, implementing new, time-efficient systems and
eliminating supply management tasks, we have demonstrated the ability to
more than double the time nurses spend with patients, with attendant
improvements in quality of care."
The entire Tefen study, "Will the Boom Bust Health Care?" is now
available at http://www.tefen.com.
About Tefen USA
Tefen USA is a subsidiary of Tefen, a global management consulting firm
founded in 1982. The company focuses on driving performance excellence to
achieve improvements in cost, quality, and service delivery. Tefen USA
supports a variety of industries and has worked with many Fortune 500
organizations. Tefen partners with clients to build quantified cases for
change, setting themselves apart by working with clients from strategy
through implementation to achieve sustainable results.
Tefen USA
http://www.tefen.com
Nou studiu: imbatranire Baby Boomers SUA ar putea distruge sistemul de îngrijire a sãnãtãþii de cãtre 2017, cu excepþia cazului în care se iau mãsuri decisive - New Study: Aging Baby Boomers Could Overwhelm U.S. Health Care System By 2017, Unless Decisive Action Is Taken - articole medicale engleza - startsanatate