As the 2024 presidential election approaches, nearly 75% of Americans say health care costs are their biggest financial concern, according to a new study from KFF. Americans have every reason to think this way: Over the past five decades, per capita health care spending has risen from $353 in 1970 ($2,072 adjusted for inflation) to $13,493 today. But the quality of care has not increased to the same extent – rather, patients today simply pay more for the same “standard treatments”.
However, rising costs and poor quality are not the result of this or that government. They are a consequence of deeper problems inherent in the American healthcare industry itself.
Greater consideration of the cost of care gives health care stakeholders the opportunity to step back and evaluate American health care as a whole. It is our job to think through system-level changes and reshape the future of health care in this country.
Fortunately, home healthcare paradigms like hospice, long considered the least institutionalized and for-profit segments of the healthcare industry, offer a model for a return to sanity in healthcare.
American healthcare is facing skyrocketing costs, forcing many patients to choose between their health and their financial stability. The statistics are staggering: Healthcare is the number one reason Americans file for bankruptcy. Over half of Americans – 57% – say they have had medical debt in the past five years.
Additionally, the United States spends much more on health care per person than other countries; Some studies suggest we spend twice as much. As the wealthiest and most innovative country on earth, our healthcare system should be the best. Instead, it is one of the worst among rich countries.
Numerous factors contribute to the rising costs of traditional American healthcare systems. One of the root causes is that many health care providers have relied on physical infrastructure, building massive campuses that have cost hundreds of millions of dollars to build and maintain, often relying on federal grants for construction and modernization.
But huge complexes are not the only option. In fact, the home and community-based care model is showing the way for a new way of delivering healthcare.
Patients often prefer to be treated at home rather than having to commute between hospitals, clinics, doctor’s offices and other care facilities. The comfort of home environment relieves anxiety and saves you the stressful time spent in traffic, searching for parking, and navigating unfamiliar medical environments. It enables patients to receive care in a familiar environment with the support of their loved ones.
The frequency of telemedicine use confirms these preferences. Before the Covid-19 pandemic, most providers did not offer telehealth options, but as physical proximity became dangerous, providers began offering them. A study found that telehealth visits increased from 840,000 in 2019 to a staggering 52.7 million in 2020. While numbers have declined somewhat since their peak in 2020, rates of telehealth use are now exponentially higher than before the pandemic.
Equally important, the home care model facilitates price control by reducing expensive real estate and physical infrastructure costs. One study found that home programs effectively reduced complications while reducing the cost of care by 30%. Another study found that the average cost of care was 38% lower and that patients at home spent a smaller portion of the day sedentary and were readmitted less often compared to patients in traditional on-campus facilities.
Critics point out that some complex procedures can only be performed in a hospital setting with expensive equipment and specialized medical staff, making it impossible to treat certain conditions at home.
I totally agree with that. Specialized campuses have their place in the healthcare ecosystem and play an indispensable role in the healthcare delivery process. However, you should not group all assessments, treatments and examinations in a single location. A major procedure should take place in the hospital; Many follow-up examinations do not need to be carried out. Annual physical exams, diagnostic tests such as blood tests, routine vaccinations and consultations often require unnecessary travel and waiting rooms. Much more healthcare can take place at home, leaving valuable bandwidth available to specialist facilities when needed.
America’s campus-based system is overbuilt and overcomplicated, leading to perverse incentives. Costs are spiraling out of control. The time for small optimizations is over. It’s time to think big, get to the root of the problem and find solutions. But before we reinvent the wheel, let’s look at existing models like home and community care to give us a blueprint.
Photo: SDI Productions, Getty Images