NPR Interview with Peter Orszag: Quality Over Quantity
May 14, 2009
In mid April, Peter Orszag, the director of the White House Office of Management and Budget, spoke to NPR about planning and implementing President Obama’s new healthcare “package”. One of the key goals of the Obama administration’s plan, beyond insuring over 10 million people in need who are currently uninsured by current policies, is to shift the focus from “more care” to “quality of care.”
“Estimates suggest that as much as $700 billion a year in health care costs do not improve health outcomes. It occurs because we pay for more care rather than better care,” Orszag says. “We need to be moving towards a system in which doctors and hospitals have incentives to provide the care that makes you better, rather than the care that just results in more tests and more days in [the] hospital.”
This doesn’t mean that the Obama administration will ask doctors and clinical workers to do less for their patients, rather, the goal would be to be more efficient and work with only the goal being the persons increased health, as opposed only to treatment or retardation of conditions.
Orszag also hit on the varying quality of healthcare in various parts of the country.
Depending on location, “the care that’s delivered to you is going to be dramatically different for reasons that can’t be explained by medical science,” he says. “And the difficulty is that the places that do more tests and [require] more time in the hospital and have you visit lots more specialists don’t seem to generate better outcomes. More is not always better in health care, and we’re wasting a lot of money because we have not transformed the system to take into account that realization.”
One of the endemic problems, Orszag points out, is that the American population does not recognize the difference between more and better care. Too often patients expect to be sent to a specialist for a condition which can and should be treated by a primary care physician. Too often patients want, for instance, to take blood pressure medication rather than see a dietician about changing their eating habits.
Another major concern is just how much of that 700 billion is caused by administrative costs – which are estimated at 16-20 per dollar spent on healthcare in the US. In Taiwan, a population widely regarded as having one of the most efficient healthcare systems on the planet, administrative costs equal about 2 cents per dollar spent in healthcare.
What can you do? How can we individually effect change on an individual basis? Does Orszag suggest firing your administrative staff? Cutting their pay? Refusing to refer patients to specialists? Of course not. If we take a look at the countries considered to have well run systems of Healthcare, there are at two practices that seem to occur in several of them.
- Palliative consultation – Beyond simple check boxes on a questionnaire, a true palliative consultation is a true evaluation of how, if at all, each patient’s lifestyle contributes to the condition being treated in order to create a “bird’s eye view” of the contributing factors to the condition.
- Patient knowledge – In France, listed by Healthcare Economist as a top ten national healthcare system, patients are expected to know their medical history front and back. Part of this expectation is on the patient’s end, they take possession and accountability for their own health information. On the other hand, part of the onus lies with US physicians, who are often regarded as being protective and unwilling to give detailed explanations and possible causes of a patient’s diagnosis.
Click here for the NPR interview with Peter Orszag
Click here for the economist.com artilce about the Healthcare industry
- Categories: Legislative Strategy
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