Being the healthcare geek that I am, I often wonder two things about the rising costs of healthcare:
1) Is anything being done today going to really impact the trend of rising costs especially with baby boomers getting older and the cost of healthcare being at its highest prior to death? Probably not.
The Dartmouth Institute for Health Policy & Clinical Practice states that 25% of Medicare’s dollars are spent in the last year of a patient’s life. As more baby boomers reach the end of their respective lives, these costs will be evident and any cost saving efforts or efforts to streamline cost, quality and outcomes (see ACOs) may not yield deep savings…at least not initially. I’m assuming that any efforts today to address the high cost/consumption of healthcare at the end of life will yield minimal cost control results by the end of the baby boom.
Oh and I’m purposely not addressing the quality or outcomes question here nor am I getting into waste or physician practice patterns – a blog for another day, perhaps!
Back to the subject at hand…
We cannot let short-term results (or lack thereof) deter us. We have to continue trying and we can’t be discouraged when drastic changes in healthcare delivery, payment, and utilization yield only minimum cost impact due to rising costs in other areas that are outside of our control. Technology costs money as well, but it also leads to better care in many cases. I should also note that we should not be tricked into thinking these cost control measures aren’t working due to the overall rise in healthcare costs.
2) What will happen post baby boom? Will all of the work we’re putting in now to promote awareness, empowerment, and consumerism become “the norm” in 50 years? Will behaviors have changed enough in 50 years so that prevention and wellness is no longer a program offered by your employer, but a way of life? Will this change lead to lower healthcare costs or at least a more controlled trend for future generations? Will the pendulum swing to the other side or at least come back to center? Is this when we’ll see the fruits of decades of effort?
OK, so maybe I’m wondering a lot more than just two things…it’s part of being a healthcare geek, I suppose.
This is where I think we will see some impact. After the high utilization baby boom period has passed, costs may normalize (meaning not be as skewed due to a higher volume of baby boomers consuming more care at the end of life). This, coupled with the education, prevention, and empowerment efforts of today will lead to sustainable behavior change. It will yield a future generation of more savvy healthcare consumers who will be living in a new era of healthcare – an era I’m calling Healthcare 5.0. (Has anyone claimed HC5.0 yet? If not…DIBS!)
So lets look past the end of the baby boom generation which, by most accounts, is only 30 to 40 years away.
The baby boom generation began around 1946 and ended in 1964. Assuming that folks live to age 80 (which in some cases will be a conservative number and others, not so much), that puts us into 2040 time frame before the baby boom generation has lived its collective life. Let’s also assume that Medicare is still solvent and the health system we have in place (or some semblance of it) is in effect. The result may be a pendulum swing back the other way. Oh and that’s also assuming we survive the continued rise of costs that may not be curbed until 2050.
Empowered patients, wiser consumption, a focus on prevention, integrated quality and coordinated care that drives better outcomes, evidence-based guidelines for the practice of care…and the dawn of Healthcare 5.0. Kind of makes me wonder what Healthcare 3.0 and 4.0 will look like…