Every year we see a number of reports with claims of tens and hundreds of billions of dollars that can be saved in health care, largely from eliminating abuse, and inappropriate care, reimbursement reforms, reduced administrative burden, etc. Yet somehow every year our health spending keeps rising faster than GDP growth or inflation. If these reports were at all accurate and acted upon, our spending should be dropping dramatically. The latest such report comes from IMS, which claims that $200 billion a year can be saved in the United States by addressing six issues in drug use: failure of patients to adhere to prescriptions; not using evidence-based prescribing; misusing antibiotics; medication errors; not using generics in every situation and not managing the therapy of people with multiple prescriptions. (IMS Report) This is a well-done report and the guesses on savings don’t seem out-of-line, but there is little credibility to the likelihood that such savings are actually achievable.
But, with this last piece in place, this last $200 billion in savings, we can now report that with all the potential savings identified in all the reports, health spending in the United States will drop to zero! In fact, below zero, so that each citizen will get a rebate, and apparently will be in perfect health, since there won’t be any use of health care or any health spending. Of course, the economic disruption of loss of tens of millions of jobs will be difficult, but in the long run the savings, particularly to the government, are astounding.