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$1.2 TRILLION WASTED : The 6 Biggest Ways Our Health Care System Throws Away Money


Health & Wellness  (tags: $1.2 Trillion, Health Care, Health Care Money Wastes, Health Care Reform, Overutilization, Pricewaterhousecoopers, Business News )

Blue
- 1845 days ago - money.cnn.com
More than $1.2 trillion spent on health care each year is a waste of money. That's half of the $2.2 trillion the USA spends on health care each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute



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Blue Bunting (855)
Monday August 10, 2009, 6:21 pm
Members of the medical community identify the leading causes.

That's half of the $2.2 trillion the United States spends on health care each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute.

What counts as waste? The report identified 16 different areas in which health care dollars are squandered. But in talking to doctors, nurses, hospital groups and patient advocacy groups, six areas totaling nearly $500 billion stood out as issues to be dealt with in the health care reform debate.
Too many tests

Doctors ordering tests or procedures not based on need but concern over liability or increasing their income is the biggest waste of health care dollars, costing the system at least $210 billion a year, according to the report. The problem is called "defensive medicine."

"Sometimes the motivation is to avoid malpractice suits, or to make more money because they are compensated more for doing more," said Dr. Arthur Garson, provost of the University of Virginia and former dean of its medical school. "Many are also convinced that doing more tests is the right thing to do."

"But any money that is spent on a patient that doesn't improve the outcome is a waste," said Garson.

Some conservatives have suggested that capping malpractice awards would help solve the problem.

President Obama doesn't agree; instead, his reform proposal encourages doctors to practice "evidence-based" guidelines as a way to scale back on unnecessary tests.
Those annoying claim forms

Inefficient claims processing is the second-biggest area of wasteful expenditure, costing as much as $210 billion annually, the PricewaterhouseCoopers report said.

"We spend a lot of time and money trying to get paid by insurers," said Dr. Terry McGenney, a Kansas City, Mo.-based family physician.

"Every insurance company has its own forms," McGenney said. "Some practices spend 40% of their revenue filling out paperwork that has nothing to do with patient care. So much of this could be automated."

Dr. Jason Dees, a family doctor in a private practice based in New Albany, Miss., said his office often resubmits claims that have been "magically denied."

"That adds to our administrative fees, extends the payment cycle and hurts our cash flow," he said.

Dees also spends a lot of time getting "pre-certification" from insurers to approve higher-priced procedures such as MRIs. "We're already operating on paper-thin margins and this takes times away from our patients," he said.

Susan Pisano, spokeswoman for America's Health Insurance Plans, said "hundreds of billions" of dollars can be saved by standardizing procedures and using technology -- something the White House has mentioned as a key to health care reform.

"For that to happen, we need the technology," she said. "Doctors and hospitals must adopt the technology, and we have to develop rules for exchanging of information between doctors, hospitals and health plans."

Pisano said the industry is launching a pilot program later this year that will allow physicians to communicate with all health plans using a standardized process.
Using the ER as a clinic

More insured and uninsured consumers are getting their primary care in emergency rooms, wasting $14 billion every year in health care spending.

"This is an inappropriate use of the ER," said Dee Swanson, president of the American Academy of Nurse Practitioners. "You don't go to the ER for strep throat."

Since emergency rooms are legally obligated to treat all patients, Swanson said providers ultimately find ways to pass on the cost for treating the uninsured to other patients, such as to those who pay out-of-pocket for their medical care.

Dees also took issue with consumers who don't get primary care for their diabetes or blood pressure on a timely basis, hence finding themselves in the ER.

"Going to the doctor for strep throat would cost $65-$70. In the ER, it's $600 to $800," he said.

The $787 billion stimulus bill signed passed by President Obama earlier this year allocates $1 billion for a wellness and prevention fund, including $300 million for immunizations and $650 million for prevention programs to combat the rapid growth in chronic diseases such as obesity and diabetes.
Medical "Oops"

Medical errors are costing the industry $17 billion a year in wasted expenses, something that makes patient advocacy groups irate.

"Do we have a good health IT system in place to prevent this?" asked Kim Bailey, senior health policy analyst with consumer advocacy group Families USA.

Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals.

The stimulus bill calls for the government to take a leading role in developing standards by 2010 to facilitate the adoption of health information exchanges across the system, including patient electronic health records by 2014.

Obama has repeatedly said that the use of technology in the health sector will help boost savings, enhance the coordination of care and reduce medical errors and unnecessary procedures.
Going back to the hospital

Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals. Discharging patients too soon is a "huge waste of money," said Swanson.

"This happens a lot with elderly patients who are discharged prematurely because of insurance, bed unavailability or ageism," she said.

Many times, patients also don't follow instructions for care after discharge. "So complications arise and they are readmitted in a week," Swanson said.

PricewaterhouseCoopers estimates the cost of preventable hospital readmissions at $25 billion annually.

Among the reform plans, one proposal being considered is for Medicare to potentially penalize hospitals who readmit patients within 30 days of discharge.
You forgot to wash your hands!

Those ubiquitous dispensers of hand sanitizer are in hospitals for a reason: PricewaterhouseCoopers estimates that about $3 billion is wasted every year as a result of infections acquired during hospital stays.

"The general belief is that hospitals are getting much better in managing this than they have in the past," said Richard Clarke, CEO of Healthcare Financial Management Association, whose members include hospitals and managed care organizations.

Something as simple as hand-washing often can reduce the problem.

"Sometimes doctors are the most difficult people to convince to do this," said Clarke. "The challenge here is that patients sometimes come in with infections which then spread in the hospital."

The stimulus bill signed by Obama earlier this year includes $50 million for reducing health care-associated infections.

Other areas of waste identified in the PricewaterhouseCoopers report included up to $493 billion related to risky behavior such as smoking, obesity and alcohol abuse, $21 billion in staffing turnover, $4 billion in prescriptions written on paper, and $1 billion in the over-prescribing of antibiotics.
 

Blue Bunting (855)
Monday August 10, 2009, 6:22 pm

Public Health Plan Could Save Money Faster: Policy Group
A nationwide health insurance exchange that includes a Medicare-like government option could save $1.8 trillion more than if only private plans are offered, a prominent private U.S. health policy group said on Wednesday.


Medicare for All (Single-Payer) Reform Would Be Major Stimulus for Economy 2.6 Million New Jobs,$317 Billion in Business Revenue

First-of-Its Kind Study: Medicare for All (Single-Payer) Reform Would Be Major Stimulus for Economy 2.6 Million New Jobs,$317 Billion in Business Revenue, $100 Billion in Wages


TransGriot: 10 busted myths about the Canadian health care system.
 

Blue Bunting (855)
Monday August 10, 2009, 6:25 pm
If Congress Fails to Pass the Obama Health Care Plan

The next time a Member of Congress tells you that he'd love to vote for the President's health care reform package but he represents a tough swing district, remind him about all the ex-members of Congress who said the same thing in 1994 and were retired by the voters to resume their careers selling insurance or practicing law.

Single Payer: Bold, Affordable, Humane
If you believe that every American has the right to quality, affordable health care, then the only affordable means to achieve that goal is through a properly financed, single-payer national health insurance program.

Follow the Money on Health Care Reform "Right now we are the only nation on earth that barters human life for money." -- Geri Jenkins, RN, co-president of the California Nurses Association/National Nurses Organizing Committee in her testimony Wednesday, in the one Congressional hearing at which single payer has been on the table
 

Blue Bunting (855)
Monday August 10, 2009, 7:05 pm
Write to the President, every day:

http://www.whitehouse.gov/contact/

Click Here For Contacting Congress State by State.

Look up your members of Congress and call them now:http://my.barackobama.com/callcongress
 

Blue Bunting (855)
Monday August 10, 2009, 7:06 pm
So, thanks to Rep. Anthony Weiner (D-NY), Speaker Pelosi says she will bring a vote to the floor on single-payer after the recess. Are you all ready to make those phone calls and write those letters?


Nancy's contact info..http://speaker.house.gov/contact/

Send our speaker an e-mail of encouragement.



YouTube - Ashes and Snow- Feather to Fire

You Do Not Have Health Insurance


http://www.truthout.org/080709A?n

The Baseline Scenario: "Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, '69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.'

Since most Americans currently have health insurance, they see reform as a poverty program - something that helps poor people and hurts them.

If that's what you think, then this post is for you. You do not have health insurance.

Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I'll come back to that later.)"
 

Blue Bunting (855)
Monday August 10, 2009, 7:58 pm

Health Care Reform: 450,000 Doctors Can't Be Wrong


The U.S. has a catastrophically fragmented health care system that provides
incentives for sick care instead of prevention. The system is in dire need of reform -- reform to save lives, to save families and money for patients and the health care system.
 

Blue Bunting (855)
Tuesday August 11, 2009, 11:03 am
Countdown Special Comment: STOP THE LIES! The Clear & Present Danger Isn't Obama's Agenda; It's GOP Talking Points


Keith Olbermann calls out the dangerous rhetoric and lies of Sarah Palin and her other GOP cohorts--such as Glenn Beck and Sen. John Cornyn--scaring the populace with their outrageous fear mongering over health care reform.
 

Blue Bunting (855)
Tuesday August 11, 2009, 4:27 pm
Lobbyist-Run Group Americans for Prosperity Provides Talkings Points To ‘Birther’ At Rep. Perriello Town Hall
 

Blue Bunting (855)
Tuesday August 11, 2009, 8:48 pm

Tea Party Organizers Admit: Goal Is No Reform At All


a group of top Tea Party and conservative organizers offered a surprisingly frank description of their goal: Completely blocking any kind of bipartisan compromise, and completely preventing any type of health care reform bill at all from ever becoming law
 

Blue Bunting (855)
Wednesday August 12, 2009, 9:35 am
Whistleblower: Insurance firms behind town hall disruptions
Man arrested at Obama event had loaded gunHeld in police custody; was also carrying pocket knife...
Stewart recalls conservative attacks on anti-war protesters
 

Blue Bunting (855)
Wednesday August 12, 2009, 1:34 pm
Republican Senator Grassley Endorses "Death Panel" Rumor/Lie: "You Have Every Right To Fear"
 

Blue Bunting (855)
Wednesday August 12, 2009, 2:05 pm
STOP PRETENDING GRASSLEY IS SERIOUS ABOUT REFORM.... Ladies and gentlemen, I present you with the leading Republican lawmaker negotiating a "compromise" on health care reform...... Grassley isn't serious about reform. Not at all. Seriously. He's proven this again and again. It's time to stop trying. Grassley will only let down reform advocates in the end.

Update: Joe Klein on Grassley's comments:
"[H]e either (a) hasn't the vaguest notion of what's in the bill or (b) he is so intimidated by the ditto-head-brown-shirts that he is trying to fudge a response to keep them happy. Either way, he should be ashamed. And once has to wonder about the fate of the Senate Finance Committee deliberations if this is what the Administration is dealing with."

Permalink
 

Blue Bunting (855)
Wednesday August 12, 2009, 2:31 pm
Obama-Nazi Sign Made By Ill Woman On Medicare

Outside, the gathering verged on a street brawl. The opposing forces lined up like screaming armies on either side of the street, about 1,000 people a side. Diane Campbell of Kingston, N.H., held a sign with Mr. Obama's face superimposed on a Nazi storm trooper, a sign, she said, that was made by her chronically ill mother.

Her mother's hereditary autoimmune disease is treated with expensive transfusions of gamma globulin, paid for by Medicare. Her sister, Louise, was born with no arms and one leg, and is also covered by Medicare, the government-run, health-insurance program for the elderly and disabled.

Read the whole story: Wall Street Journal
 

Blue Bunting (855)
Wednesday August 12, 2009, 2:59 pm

Professor Stephen Hawking Enters U.S. Health Care Debate
"I wouldn't be here today if it were not for the National Health Service," he told The Guardian. "I have received a large amount of high-quality treatment without which I would not have survived.
 

Blue Bunting (855)
Saturday August 15, 2009, 1:37 pm
* After all the fuss about every lawmaker reading every word of the health care bill, Senate Minority Leader Mitch McConnell (R) of Kentucky opposes reform despite not having read the legislation.
 

Blue Bunting (855)
Sunday August 16, 2009, 12:54 pm
The argument over which system is better at this point is like arguing whether or not global warming is real and human caused. Everyone knows the answer, but some people can turn a profit by denying it.


Who, in the eyes of Canadians, is THE most popular Canadian? Tommy Douglas, the father of the Canadian Medicare System. Watch this video.


http://link.brightcove.com/services/player/bcpid1463312787?bctid=1463302784


(Also posted at www.lftwings.org.)

Remember, Canada didn't get UNIVERSAL HEALTH CARE all at once; it happened Province by Province nd the government could no longer deny Canadians the health care they demanded.
 

Blue Bunting (855)
Sunday August 16, 2009, 1:08 pm
COMPARE health care in:

Australia
http://www.health.gov.au/internet/main/publishing.nsf/Content/Home
Canada
http://www.hc-sc.gc.ca/...

England
http://www.propertyshowrooms.com/...

USA videos
http://www.youtube.com/...
http://www.youtube.com/...

From: "Health care system and health care reform in Germany"

http://www.bmg.bund.de/cln_160/nn_1169696/EN/Gesundheit/gesundheit__node.html?__nnn=true


This is the official website of the Ministry of Health and Social Matters in Germany

Quote:

"However, a health care system is not a "normal" market. After all, it places even more importance on care standards and service quality than other sectors do. Here, too, Germany scores high on quite a few counts:

* It is far easier to obtain out-of-hours medical attention here than in most other countries and, very importantly, this is so regardless of income or insurance status.

* Wait times for hospital care ... are shorter here than elsewhere.

Also, no such thing as "Preconditions" exists in Germany!

And

"Universal coverage

From now on, all citizens in Germany will enjoy health insurance coverage. From 1st January 2009, and for the first time in German social history, all residents are obliged to take out health insurance unless they are otherwise covered. Persons who had lost their insurance cover must return to their most recent insurer. This applies to the statutory and the private insurance system alike. "

Addendum: If someone cannot pay for his own health insurance (minimum wages apply), the state pays the premiums. This is a legalized RIGHT for citizens of Germany!

Don't opt for less, Americans! Don't let them tell you, it can't be done - because it can!

If we can, then you can, too. YES, YOU CAN!




WENDELL POTTER IS MAKING SENSE....
I wish Wendell Potter was a household name right now. His message and perspective is arguably as important as any in the country. Potter first came to public attention about a month ago, when he sat down with PBS's Bill Moyers. We learned that he's a former executive at a major health insurance company, who's become a whistleblower, explaining the way the industry "put profits before patients" and is doing everything possible to block health care reform now.

Slowly but surely, he's gaining more prominence. Last night, he spoke with CNN's Anderson Cooper, who almost seemed surprised by what he heard.

"The way it works is that the [insurance] industry will hire big PR firms that create these front groups that have names that have no association with the insurance industry," Potter said." And it is these front groups that do the things that you're seeing right now that try to destroy health care reform by using terms like 'government takeover' of the health care system. Or we're heading down toward a 'slippery slope toward socialism.' Or we're going to 'kill your grandpa' because of this health care reform bill.

Cooper asked, "You're saying that language is written by insurance companies?" Potter responded, "Absolutely."

Asked about the right-wing activists, Potter explained that the industry has "very close ties with the conservative radio talk show hosts and commentators and editorial page writers and they feed the talking points."

Potter also spoke to Rachel Maddow this week. "I think that the health insurance industry deserves a great deal of the blame because they're very much behind the town hall disruptions that you see and a lot of the deception that's going on in terms of disinformation that many Americans apparently are believing," he explained.

Asked about a public option, and whether private insurance companies would be able to compete alongside a government-run non-profit plan, Potter added, "Well, they could, absolutely. I've seen the health insurance industry change its business models many, many times. The insurance companies who operate now are very different from the companies that operated a few years ago. They adapt very quickly. And the one thing they know how to do is make money."

Here's hoping that Potter, given his background and unique insights, gets a whole lot more media opportunities.

.....

So, thanks to Rep. Anthony Weiner (D-NY), Speaker Pelosi says she will bring a vote to the floor on single-payer after the recess. Are you all ready to make those phone calls and write those letters?


Nancy's contact info..http://speaker.house.gov/contact/

Send our speaker an e-mail of encouragement.
 

Blue Bunting (855)
Sunday August 16, 2009, 2:17 pm
Froomkin on the week's Cheney-related revelations: "Indeed, it's worth pointing out that pretty much anytime we find out something new about the Bush era, the result is profound, consistent vindication for all the central pillars of the Bush critique chronicled in my washingtonpost.com column and elsewhere over the years. But here's the thing. I'm getting oddly little satisfaction from this -- because I'm increasingly troubled about this presidency. At the heart of all the tragedies of the Bush years was the White House's fundamental untrustworthiness. They didn't tell us the truth. And sometimes -- more often than we still want to believe -- they flat-out lied to us. Lack of transparency was also a fatal flaw. When people can't see into the White House (and the people inside don't want to look out) bad things happen. As they surely did."
 

Blue Bunting (855)
Sunday August 16, 2009, 2:23 pm
The brutal truth about America's healthcare vs Stephen Hawking, who said, "I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.." And a student who suddenly found himself unable to move and had to be supported by his wife would not have been able to get that sort of care in the United States at all, let alone be kept alive and allowed the time to think that made it possible for him to become *the* Stephen Hawking.
 

Blue Bunting (855)
Sunday August 16, 2009, 4:33 pm
WHITE HOUSE STILL BACKS PUBLIC OPTION
 

Blue Bunting (855)
Monday August 17, 2009, 11:09 am
Krugman: All That Stands In Way Of Universal Health Care Is Greed, Lies And Gullibility

Howard Dean On Public Option: "You Can't Really Do Health Reform Without It"
 

Blue Bunting (855)
Tuesday August 18, 2009, 5:32 pm
WATCH: Man Who Brought Assault Rifle To Obama Rally Was Part Of Radio Stunt

The man with the semi-automatic (referred to in interviews as "Chris," no last name) was spotted at the protest by CNN news cameras, in the middle of a Q&A. Today, his interviewer -- Ernest Hancock of conservative talk radio show Declare Your Independence With Ernest Hancock -- went on CNN and explained to host Rick Sanchez that he and Chris were actually in the middle of a radio broadcast. Hancock, also packing heat at the rally, had invited Chris to come down the protest with his rifle to be interviewed. The two men had known each other for two years, through their work for presidential hopeful Rep. Ron Paul (R-Texas).

During the segment on CNN, Rick Sanchez said, "the more we look into this, the more it appears that it was really planned." Hancock concurred: "Oh, it's more planned than you think." In addition to scheduling the interview, Hancock had also informed the local police force.

As the interview continued, Rick Sanchez loudly exclaimed, "This was a publicity stunt!"

"Oh absolutely," Hancock responded.

Sanchez pushed on, "isn't there something terribly disingenuous about putting people on like that? And isn't there also something a little bit... dangerous about playing these kinda games--"

"Oh, it's not a game," Chris interjected.

"---with what I imagine is a loaded weapon," Sanchez continued.....

Chris is also featured in a YouTube video produced by the libertarian group Freedom's Phoenix. In this video he expounds further on his right to bear arms. He also explains that he is "absolutely totally against health care... health care in this way, in this manner, stealing it from people. I don't think that's appropriate."
 

Blue Bunting (855)
Wednesday August 19, 2009, 2:57 pm
BE THERE ... 9/12/2009 in D.C.


The place to organize for the March on DC
I just wanted to remind everyone that you can connect with other people in your state by joining our ning social networking site. JOIN NOW and find a bus to ride in on, or a caravan of cars coming from your area. Connect with others in your state and work together to spread the word!
The [...]

Full Story»
 

Blue Bunting (855)
Saturday August 22, 2009, 10:41 am

"Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter? Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed in America."

Whole Foods CEO, John Mackey in arecent Wall Street Journal op-ed on health care.

Whole Foods Backlash & Boycott: Bloggers Outraged Over CEO's Anti-'ObamaCare' Column
 

Blue Bunting (855)
Wednesday August 26, 2009, 1:15 pm
Gang Of Six Republican Admits He's Just Blocking Health Care Reform
Mike Enzi told a Wyoming town hall crowd that he had no plans to compromise with Democrats and was merely trying to extract concessions. Enzi's blunt portrayal of his real role in the negotiations makes bipartisan compromise that much less likely to emerg
 

Blue Bunting (855)
Thursday August 27, 2009, 8:29 am
McCain Evicts Angry Woman From Town Hall
 

Blue Bunting (855)
Friday August 28, 2009, 1:07 pm
Veterans For Common Sense: Veterans demand an apology from the Republicans and FOX for lies about the VA
 

Blue Bunting (855)
Monday August 31, 2009, 2:22 pm

Republican Rep: We'll Repeal Health Care Reform If It Passes
 

Blue Bunting (855)
Wednesday September 2, 2009, 10:36 am

Who Will Be Hurt if the Democrats Pass Health Care Alone
If the Democrats pass the health care bill, and are able to do it with a public option, the Republicans will have once again put themselves on the opposing side of groundbreaking legislation.
 

Blue Bunting (855)
Wednesday September 2, 2009, 5:55 pm
When it comes to healthcare, there is no lie a conservative will not tell.
 

Blue Bunting (855)
Thursday September 3, 2009, 9:57 pm
Why Health Insurance Reform Will Pass This Fall -- It's the High Political Ground

Health insurance reform represents the high political ground for four major reasons:

1). Most Americans - including swing voters - can't stand the health insurance industry. As Congress reconvenes, the Administration and its allies will unleash a major drive to correctly define the battle as a contest between the interests of private health insurance companies and ordinary Americans. Health Care for America Now (HCAN), the big coalition of progressive organizations and Labor, will put it this way: If the insurance companies win, you lose. ....

2). The Obama Administration will use every ounce of its political capital to win this battle. The President and his top advisors understand that -- when it comes to health care -- failure is simply not an option. They know that defeat on health care would be a huge blow to the President's ability to pass his entire agenda and his own standing with the voters. People follow successful leaders - not those who fail.

As a result, the President will use every bit of his charm, his persuasive ability and the formidable powers of the Presidency to secure the votes to win.

And make no mistake. While Barack Obama would prefer a bi-partisan bill passed through the regular order with broad consensus, he has an iron will and will pass a bill by one vote using special budget procedures if that is necessary to win. He is a huge fan of Lincoln's Team of Rivals, but in matters of legislation his model is Lyndon Johnson.

Anyone who doubts the strength of his resolve - or his resourcefulness - doesn't yet understand Barack Obama.

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