The inconvenient truth! Lesser care at higher costs...

LinkedIn is unique in the world of social media in my perception. It seems to be filled with diverse opinions on many things including healthcare. The platform brings business, investors, physicians, nurses etc.. into a unique sharing and spinning of information. Just in the past few weeks I have read articles on the following:

The doom of healthcare and the US's poor ranking

The greatness of the affordable care act and the improvements made

The blame toward physicians, hospitals, insurers or the government for problems

The need for more direct to consumer digital health and "virtual" primary care

More apps that can offer video visits and prescriptions for one disease

The fundraising success of some hopeful future "unicorns" in healthcare

The poor financial reports and discounted sale price of other sure "unicorns"

Discussions that that transparency and price shopping is needed by consumers

The need for more MBA's among nurses and physicians and a new suggestion that physicians should own hospitals.

How about Fee for Service vs Value Based Care - always a hot topic

Finally, our opinions on why nurses and physicians are suffering "burnout".

So my question, with all these opinions and ideas from pundits, influencers, experts and folks like me etc.. is it time we look at the actual numbers? In the table above, you will see the trend for healthcare spending every 10 years.. You can also read articles in 2007, 2014 and 2021 showing us in dead last compared to other countries based on our performance.

You can find the actual detail from CMS and the National Health Expenditure website... Some highlights

NHE Fact Sheet

Historical NHE, 2021:

• NHE grew 2.7% to $4.3 trillion in 2021, or $12,914 per person, and accounted for 18.3% of Gross Domestic Product (GDP).
• Medicare spending grew 8.4% to $900.8 billion in 2021, or 21 percent of total NHE.
• Medicaid spending grew 9.2% to $734.0 billion in 2021, or 17 percent of total NHE.
• Private health insurance spending grew 5.8% to $1,211.4 billion in 2021, or 28 percent of total NHE.
• Out of pocket spending grew 10.4% to $433.2 billion in 2021, or 10 percent of total NHE.
• Other Third Party Payers and Programs and Public Health Activity spending declined 20.7% in 2021 to $596.6 billion, or 14 percent of total NHE.
• Hospital expenditures grew 4.4% to $1,323.9 billion in 2021, slower than the 6.2% growth in 2020.
• Physician and clinical services expenditures grew 5.6% to $864.6 billion in 2021, slower growth than the 6.6% in 2020.
• Prescription drug spending increased 7.8% to $378.0 billion in 2021, faster than the 3.7% growth in 2020.
• The largest shares of total health spending were sponsored by the federal government (34 percent) and the households (27 percent). The private business share of health spending accounted for 17 percent of total health care spending, state and local governments accounted for 15 percent, and other private revenues accounted for 7 percent.

I may be the contrarian, but I think we are on a very difficult trajectory of paying more and more for lesser outcomes. While I appreciate the opinions of so many it's unfortunate that we don't seem to be paying close enough attention to the outcomes of our actions.

Is more insurance making care "more affordable?" Have we changed the trajectory of the sickest, neediest or most neglected populations? Is fee for service helping or hurting our costs and outcomes? Is the government charting a course to better? Does productivity, access, convenience really drive better care or lower costs?

In the prior weeks I discussed the blame game in healthcare. It's really not getting us where we need to be.. at least that's what the data tells me. Over the coming few weeks, I will provide insight from what I see in the pediatric emergency department and witnessing how disconnected our "system" has become. My hope is to offer some enlightenment for those that don't get to see the inner workings or dysfunction.

We all have to take some accountability for this mess.. don't we?