Waste in the US Health Care System: Estimated Costs and Potential for Savings | Health Care Policy | JAMA | JAMA Network

ECO- HEALTH .   CAN WE GO GREEN ?

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Can we become Green doctors and patients?  Our current focus on  health reform has been to make it more efficient and less costly.  Our country shares two statistics that are shameful.  . We suffer with the highest costs globally, and we are one of the most polluting country in the world.


Audio click .   William Shrank .
 

The term "eco-health' also refers to  the effect of our environment on personal well-being.

The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health care spending may be considered waste. Despite efforts to reduce overtreatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains.

This review used the framework of 6 domains of waste that guided previous work (failure of care delivery, failure of care coordination, overtreatment or low-value care, pricing failure,  fraud and abuse, The estimated annual savings from these interventions ranged from $22.8 billion to $30.8 billion.) administrative complexity)2,3 and added estimates of the cost of low-value care to the “overtreatment” domain (Table 1).

Low-value care was defined as services that provide no or minimal benefit to a patient in a specific clinical situation.15 In addition to new evidence on the cost of waste, evidence regarding cost-saving interventions was reviewed to provide estimates of potential waste reduction in each domain if those successful interventions were scaled. 

Two articles addressed cost of waste from administrative complexity (Table 2), and no articles were identified that addressed savings from interventions. The estimated total annual cost of waste in this category was $265.6 billion.

This review of the current literature of the cost of waste in the US health care system and evidence about projected savings from interventions that reduce waste suggests that the estimated total costs of waste and potential savings from interventions that address waste are as high as $760 billion to $935 billion and $191 billion to $282 billion, respectively. These estimates represent approximately 25% of total health care expenditures in the United States, which have been projected to be $3.82 trillion for 2019.

Patients and providers alike must learn about and question why their physician orders a test or a treatment. Both are subject to commercial marketing practice and competition amongst laboratories, imaging services, hospitals, clinics and pharma for their share of the marketplace.

68 of the greenest hospitals in America | 2018

In addition to financially going Green, a focus on minimizing pollution, increasing recycling, and improved energy efficiency are of paramount importance. While other industries are giving attention and resources to these issues, health care has not.  Cogeneration and alternate sources of energy have been ignored by hospitals and large medical clinics. There is little competition from medical device manufacturers about energy efficiency of their products.

Waste in the US Health Care System: Estimated Costs and Potential for Savings | Health Care Policy | JAMA | JAMA Network: This Special Communication uses a systematic literature review to update previous dollar estimates of waste in the US health care system attributable to failure of care delivery and coordination, low-value care, price inflation, fraud, and administrative complexity.