In spite of some of his crazy ideas, RFK, Jr is on the right track that the first thing we need to focus on in promoting healthy habits. I struggle in this area as most Americans do.
It sounds simple, but if we could bend the curve on metabolic diseases by eating healthy diets, getting enough sleep, exercising regularly, and where possible minimizing stress, the impact would be unbelievable. Everyone could enjoy great health care at less than we pay for health care today.
However, regardless of how healthy we are, we will all need health care at some time or another. To hold down the cost of health care, we need to focus on doing things right the first time.
Over utilization, underutilization, and bad habits all lead to bad outcomes and higher costs. As you said, this is easier said than done, but it can be done, and there are plenty of case studies that use evidence-based medicine and CQI to improve outcomes. But it won't be how our health care system works until profits are linked to healthy outcomes.
Finally, total health care costs are a function of utilization expressed as "units of care" and price per unit of care (based on the specific type of care). This can be very complex, but our country is full of smart people who can figure this stuff out, if we really want to.
Our health care system is very transactional, so providers profit from providing units of care rather than reducing the need for health care.
I appreciate what you wrote, but I also remain frustrated with the reality that politicians spend so much time arguing about things that don't matter.
Unless we build our health care system around providers profiting by keeping people healthy, we will generate a system where providers make money delivering care whether it is needed or not. It is scary knowing that the open-heart surgery rate in a given community is tied more closely to the number of open-heart surgeons, than the demographics of the patient population. It is tragic that most pharma research is focused at very expensive drugs rather than expanding the use of generics to treat other diseases. It makes you mad knowing, that a bad outcome from a surgery produces more profit than a good one.
I agree health care is a very emotional topic and at one level people deserve to be angry. But far too often the target of their anger is misplaced. I lost a doctor from a husband who killed him when he returned to work after lunch. The doctor was one of the best oncologists in his field, but cancer is a bad actor, and people with cancer die. In this case, the man's wife died. As a result, potentially hundreds of people that might have gotten care from this physician never will.
But rather than focus on how to make Americans healthier and treat diseases better, politicians seem focused on whether the government should control the health care system or not. My response to that is once the VA is the best health care system in the country, then let's talk about it. I won't hold my breathe. Now let's get back to figuring out how to make Americans healthier and deliver care more efficiently with better outcomes.
