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The elephant in the waiting room

By Jay MacDonald ·
Tuesday, September 11, 2012
Posted: 10 am ET

While President Barack Obama and Republican presidential candidate Mitt Romney thrust and parry over Medicare, Medicaid and Mr. Romney's own Massachusetts health care reform, both campaigns tend to ignore the elephant in the waiting room: the runaway waste in America's health care system.

A new report out last week by the independent Institute of Medicine, "Best Care at Lower Cost," drops the bill right in our lap: Based on 2009 statistics, U.S. health care wastes $750 billion per year, or roughly 30 cents of every dollar spent, due to a system that, contrary to political rhetoric, hardly qualifies as a free market.

In fact, the physicians, public policy experts and hard-knuckled business people who comprise the 18-member IOM panel concluded that U.S. health care "falls short on such fundamentals as quality, outcomes, cost, and equity. Each action that could improve quality -- developing knowledge, translating new information into medical evidence, applying the new evidence to patient care -- is marred by significant shortcomings and inefficiencies that result in missed opportunities, waste, and harm to patients."

That last one would have Hippocrates spinning in his grave. The panel found that one-third of all hospital patients are harmed during their stay. Then again, if they knew what their care was going to cost, those numbers might run even higher. The report said this information is often lacking.

In any other business, you might survive, though not for long, with a 30 percent hole in your boat and no systematic way to monitor, much less improve your buoyancy. But as the panel points out, in health care, the enormous waste -- waste that you and I are paying for in the form of skyrocketing health insurance premiums -- has very human consequences.

"Every missed opportunity for improving health care results in unnecessary suf­fering. By one estimate, almost 75,000 needless deaths could have been averted in 2005 if every state had delivered care on par with the best per­forming state," the report says.

It's not as if health care lacks data; modern medicine is arguably the most data-intensive industry on earth. The problem instead is that, much like the old Internet analogy, it's all piled up in the center of the (waiting) room and few are sorting and sharing it efficiently or effectively, either among themselves or, more alarmingly, with you, the patient.

The report makes clear that, contrary to campaign rhetoric, eliminating systemic waste from our health care system -- that is, ultimately spending less -- may not only rein in the cost of health care but actually improve the quality of care we receive.

Let's hope that whatever the outcome of November's presidential election, the health care industry will embrace the IOM recommendations and take two every 12 hours as its own prescription for wellness. Do you agree?

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