Occupy medical and healthcare knowledge

Have we begun to bend the cost curve in healthcare? Will this continue? And how can we make it a great reality?

Steven Tucker, MD linked to a recent article in The Atlantic titled, ‘The Exponential Growth in U.S. Health-Care Spending is Slowing, and It’s Not Because of the Recession’

Healthcare’s rising cost year over year is referenced to the rising insurance premiums and the reality of medical bankruptcy for a single illness. The article presents data from New England Journal of Medicine that shows that an analysis of monthly data since 2003 demonstrates a moderation in growth of spending began back in 2008 and continued through May 2012.

“Our analysis of monthly data on health care spending shows that the moderation in growth began well before the recession and has continued through May 2012.”

“Excess growth decreased from more than 3% during 2003 to less than 1% starting in July 2005 and continuing, for the most part, until near the end of the recession in June 2009. Excess growth exceeded 1% during the post-recession period, until May 2011, when it again dropped below 1%, going negative during the latter part of that year. If we use 1% as a threshold to denote moderation in excess health care spending, these data show that July 2005 marked the onset of moderation.”

Spending on personal healthcare began to fall two years prior to the recession and was more pronounced during the recession. There is no clear reason why this has occurred.

A companion article in The Atlantic, ‘A Footnote in History: Why the Obamacare Ruling May Not Matter” addresses some of the trends in healthcare that may be impacting changing behavior and slowing cost increases. Those changes include the healthcare industry looking at scale and efficiency, including Accountable Care Organizations, coordinated care, employers actively managing costs of both insurance premiums and wellness programs, and Health Savings Accounts. Included this article is a discussion of some of the other trends happening that are impacting cost. These include changes in how patients get care, where healthcare providers practice, growth of community and pharmacy-based health centers, technology, generic medicines, and alliances between hospitals, providers and employers to manage cost.

There is one telling paragraph that captures the how and why of this tend and may in fact bode well for the continuing downward tend in costs:

‘Added to this is that the compelling narrative of waste and error in U.S. health care has gotten traction, in books, articles, movies, and simply in evolving patient perceptions of care. What this means is that the automatic deference to the knowledge of doctors and the wishes of hospitals is eroding fast, adding a dimension of consumer pressure to the mix of forces demanding reform.’

Pressure from the largest and most important segments in this equation—us patients—is perhaps the single most powerful driver of change. Consumers and patients are the ones who should and must take control of our healthcare. We must manage how our healthcare is delivered and what we receive for each dollar spent. This is witnessed in the number of people using the Web to learn about health and medicine, social media, ePatients, Patients Like Me, and healthcare providers who are embracing the reality that patients are not a blank canvas to which to paint care on but cooperative partners to improve outcomes and manage costs. Consumers and patients are learning and growing in their knowledge and understand of what healthcare is what it means to us individually and nationally.

The change in healthcare has begun: we cannot return to the good old bad days. Occupy Healthcare is here to engage healthcare providers and consumers alike to learn to change and impact care. Knowledge and engagement are power we cannot afford to surrender to a ‘free’ market driven by profit and greed. God and nature may have caused a serious illness but God and nature won’t ensure we will receive care that is affordable and effective. We with our healthcare providers, protected by laws designed to ensure we all have an equal chance to get care, will succeed in improving our national healthcare at an affordable cost.