Around the time Barack Obama became President, I ran a health IT beat for ZDNet.
One point hammered home to me was that 75% of America’s health care bill relates to chronic conditions. These are things like heart disease, diabetes, and complications from smoking or drinking.
The way to cut the bill is through preventive care, I learned. Make sure people see a doctor regularly. Use those visits to monitor their condition, to hector people about their choices, and to get us to take our medicine. Keep us out of the hospital and everyone wins.
Obamacare covered that, for most people, especially those on Medicare. It also covered the cost of computerizing clinics and hospitals. While too many people are still forced to fill out too many forms, there are now electronic records on most of us. Hospitals can find out what patients are supposed to be doing and (through test results) whether we’re doing it.
Somehow The New York Times thinks this is a big mystery. The cost of Medicare has flattened out at around $12,000 per person. We’re having fewer heart attacks and strokes, thanks to statins and hypertension drugs. Primary care has moved out of high offices and onto the street, with nurse practitioners and physician assistants given more power by data.
The idiots at the Times can’t resist spinning this as bad news. “The cost containment strategies in hospitals may mean patients have been denied the treatments of their choice,” they write. This may be the most asinine sentence I’ve read all year. The idea that doctors and data should control health care choices, when paid for by public or private insurance, should not be controversial. You can’t have an unlimited draw from a limited pool of funds. Doctors steering patients to expensive “therapies,” and patients demanding treatments they just saw on TV, are how we got into this mess in the first place.
The point is that much more can be done. If everyone is getting preventive care, if everyone is being advised on how to keep from getting sick, if everyone is being monitored to take their medicine, we can drive costs down further.
But that would require giving everyone access to the health care system.
And that’s still not happening.