The PWC Health Research Institute finds the current health system in the United States seriously wanting and suggests that new entrants may cause radical shifts in its makeup. (PWC Report) The paper starts with the usual litany of how expensive and disconnected our system is and how that doesn’t get us better outcomes. The most offensive statistic that keeps get repeated when people start bashing the system is that more than a third of spending is wasted. This is a hyperbolic estimate which has no basis in the research or common sense. The authors then postulate the development of a “New Health Economy” in which, among other things (hold your breath now) “the mere collection of data will be rep;laced with lightning-fast analysis delivered directly to a care team that anticipates problems before they arise.” Wow, who woulda thunk it! Like Psych, only for health care. Patients will be consumers first. Purchasers–individuals, governments, employers–will direct payment to entities providing the best value, which might not be a traditional provider. And on and on. Anybody buy a fitbit lately. Oh I forgot, that was so last year.
Don’t mean to unduly bash this particular report, there are lots of other similar ones out there. Yes, there is a subset of consumers who are eager to spend money on health improvement and wellness gadgets and apps and yes most large companies are attracted to the sheer size of the health care market and trying to figure out some way to grab a piece of that, from big tech companies to wireless carriers to consumer brand companies. And yes, for some types of basic services, retail clinics and online and phone consultations offer greater convenience and lower per unit costs. But this is nibbling at the edges, not affecting where the biggest buckets of cost are. And it is not clear that all the new-fangled things are completely substitutive as opposed to additive. And there isn’t much they can do to make a hundred thousand dollar course of treatment for a HepC drug less expensive. The flashy stuff gets the attention, but very good care management for very high cost individuals is what would likely make a real difference in national health spending.