Here’s what I believe we need to do to change healthcare.
#1 Change care delivery by mandating “evidence-based” medicine.
Evidence-based medicine comprises guidelines for best practices that have been established by practitioners from both research and medical outcomes studies.
In the U.S., only 59% of Medicare patients with cancer receive best practices, according to NQA. Only 55% of all U. S. patients receive recommended care, according to RAND. Moreover, there is a 40% variation in treatment for the same diagnosis. With evidence-based medicine, this would be reduced to near zero! We could truly predict treatment results.
Evidence-based medicine would also change our malpractice system, which has 1+% direct costs (awards, legal fees, administration, etc. of which the harmed patient receives only 46%) and about 9+% for the indirect costs of “defensive medicine” according to a recent Quarterly Journal of Economics study. Additionally, a George Washington University study has pointed out that fraud would be easy to recognize as outliers would become obvious. This change would save an additional 10%. So, these two modifications, alone, would reduce costs by about 20%.
#2 Emphasize prevention.
Only 3% of Americans don’t smoke, stay close to ideal body weight, exercise three times per week for at least 20 minutes, and eat fruits and vegetables regularly, according to David Nash, a respected Professor of Health Policy at Thomas Jefferson University in Philadelphia. 70% of illnesses in America today are self-induced. The remaining 30% of illnesses are genetic in origin. 90% of resources are spent on illness and not health promotion.
We simply must change our priorities.
I’m pleased to say that’s exactly what we’re doing with the Blue Zones Project in 80 communities for 5+ million folks.
Our overall mission is to help people live longer, happier, and healthier lives. Of every dollar we spend on healthcare, 75 cents goes towards patients with chronic illnesses like diabetes, heart disease, cancer, and asthma—many cases of which could have been prevented entirely, detected earlier, or better managed. In Medicare and Medicaid, the numbers are even worse—we spend 83 cents and 96 cents per dollar, respectively, on chronic illnesses.
The point is that we are all in this together. America has 5% of the world’s population and produces 20% of the world’s gross national product. We live in a global environment and need to continue to be as efficient and effective as the best countries in the world.
America has a long and proud history of leading the world. We should continue this tradition of healthcare excellence by embracing first, evidence-based medicine and second, prevention—two changes that would have an enormous impact in both reforming and improving our national healthcare.