People

Five Uncomfortable Truths About U.S. Health Care


By Ryan Holeywell | January 10, 2018

Medical professionals are used to speaking frankly with their patients—when a condition is worsening, or a treatment isn’t effective—but they’re not always so comfortable speaking frankly about themselves.

The Texas Medical Center Health Policy Institute hosted a lively discussion of expert panelists Tuesday, Jan. 9, including physicians and nurses, health policy experts, a pharmacist and an attorney. Here are some of the most shocking truths they revealed about the state of U.S. health care. A full video of the event is available here.

1. We don’t have the best health care in the world. The U.S. has the highest health care costs in the world by all metrics. But what does it have to show for it? Consistently, the country ranks around 50th in the world for both life expectancy and infant mortality. We’re good at medical care, but health care is a different story. “We’re terrible,” said TMC Health Policy Institute Director Dr. Arthur “Tim” Garson Jr.

2. Doctors often blame malpractice suits for the high cost of health care. Instead, they should look inward. Garson cited a recent survey of doctors in which more than 70 percent said physicians are more likely to perform tests and procedures when they profit from them. Another well-known study estimates that the cost of overtreatment—subjecting patients to care that can’t possibly help them—is as much as $226 billion per year. If doctors only did what was necessary, instead of what was profitable, we could stop or reverse rising health care costs.

3. Health care could be more efficient and more effective if providers cooperated more. For too long, health care systems have insisted they own patient data and have been unwilling to share it, said University of Houston College of Pharmacy Dean F. Lamar Pritchard. Despite the promise of electronic health records, health care providers have been surprisingly slow to embrace them, he said. That means patients often have to undergo redundant, duplicate tests, simply because different health care providers won’t share results from labs and tests. It’s only very recently that patients have been able to get results directly from labs themselves, said Jessica Roberts, director of the University of Houston Health Law & Policy Institute.

4. Our society isn’t great at targeting disease prevention efforts where they matter most. Our life expectancies are mostly determined by behavioral patterns, genetic predispositions and social circumstance. Medical care, on the other hand, accounts for just 10 percent of our life expectancy, according to a well-known study. As a country, we’d be better off taking a broader view of disease prevention instead of focusing on the health care setting. Pritchard cited the fate of young children predisposed to developing Type 2 diabetes because of genetic and environmental factors. “By the time the Type 2 diagnosis is made … the horse is out of the barn,” Pritchard said. “It’s too late.”

5. If you think all of this will change any time soon, think again. Reducing the cost of health care often means reducing health care providers’ profits. For example, there’s been substantial research on how to reduce the rate of readmissions, or people who are hospitalized after undergoing a procedure. But hospital executives don’t have a financial incentive to cut that rate, Garson said. In other words, big players have a stake in maintaining the status quo. “Any time you talk about major change, you have eruptions from those who don’t want to give up a dollar they’re earning,” Pritchard said. “As much as we want revolution, I think we’re stuck with a very, very slow evolution. It’s going to take extraordinary leadership to say ‘enough is enough.’”




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