January is a poignant time look to the future, and one area of continuing concern is the cost of health care in the United States. Not only are record numbers without insurance, but the astronomical costs of Medicare and Medicaid threaten the financial underpinnings of our society. Some projections show that by 2050, when I turn 70, ” government health care spending will claim one-third of GDP.”
By the time we reach those kind of numbers, the American economy will have bigger problems than health care provision. Ridiculous debt? A default on the dollar? Unfortunately for the rest of the world, the US economy and it’s dollar are too big to fail without dramatic repercussions.
When looked at from that perspective, it shows how superficial and, frankly, irrelevant that whole health care sideshow of 2009 and 2010 was. You want single payer? You want a public option? Neither of those get close to looking at what will be required for the bigger picture, it’s just fiddling on the edges. Furthermore, the sheer divisiveness and ugliness of the process may end up being the highest societal cost in the long run.
The word holistic gets quite a battering in popular culture, but the concept of holism could not be more apropos in this particular discussion, as holism is the bigger picture. So over the next year, a series of special blogposts in a seperate section of our website, will look at health care economics from a holistic perspective, and we will see how we can incentivize the right shifts that will give America the underlying fundamentals that will be necessary for sustainable health care.
MEASURING CHANGE
One of the most easily understandable tools for deduction used by health care economists is a “Quality Adjusted Life Year”
A quality-adjusted life year (QALY) takes into account both quantity and the quality of life generated by healthcare interventions. It is the arithmetic product of life expectancy and a measure of the quality of the remaining life years.
A QALY places a weight on time in different health states. A year of perfect health is worth 1; however, a year of less than perfect health life expectancy is worth less than 1. Death is considered to be equivalent to 0, however, some health states may be considered worse than death and have negative scores.
With QALYs, we now have a method to be able to start making numerical calculations for best patient outcomes. We will use this methodology show where the different forms of medicine are used most effectively and hopefully come to an economic, rather than clinical, rationale for integrative medicine.
We hope those of you interested in this topic will share your thoughts in the comments. This is a salient issue and we need to start to have a serious conversation about the sustainability of our health care model.
James Maskell
CEO HPd
