The forms, however, whether for an insurance company or government agency, tend to be different in format. They often repackage the same basic information. If forms were standardized, there would be a savings of thousands of hours of paperwork and billions of wasted dollars in the healthcare system.
Even greater changes in healthcare costs, however, require changes in public health. National statistics show 70% of all healthcare costs are generated by 10% of patients. Much of this reflects care provided as we age. But smoking adds an estimated $208 billion to healthcare costs each year and obesity another $117 billion.
Changing health habits after they have been established is not easy. But, what if we imprinted the population early with healthy habits?
If we made a concerted effort to instill healthy behavior in children, we would likely see a dramatic change in the healthcare they need as adults and the costs of their care. Of course, it may not work for everyone, but it could make a significant change for many people.
To achieve these goals will mean integrating health literacy about nutrition, exercise and all other health promotion activities into the school curriculum. It is essential that we teach good health continuously with the same priority we teach the basics of literacy and mathematics. It should start in the earliest grades of elementary school and continue as a regular part of the curriculum.
Early healthcare literacy would be an effective influence for health promotion. It would require little investment and produce healthy children, who in turn would grow up to be healthy adults and health advocates. This would lead to a reduction in preventable illness and also reduce our national healthcare bill.
Malpractice reform is another area of need and is tied to access as well as cost. There are parts of our country where it is difficult to find a doctor to deliver a baby, and there are other medical specialists who are in short supply. Maternity programs have closed in New York, Philadelphia, New Jersey and many other parts of the country.
The primary reason is the cost of malpractice insurance. Premiums for an obstetrician can be more than $200,000 a year near major metropolitan areas. These costs can drive physicians out of business or be passed on to increase costs to patients, which also increases the cost of health insurance.
If a panel of healthcare and legal experts examines the merits of a malpractice suit before trial, millions of dollars could be saved that now are used to settle questionable claims. People hurt by medical mistakes should receive appropriate compensation and receive it in a timely way. Excessive administrative and legal costs could be reduced. As a result, necessary doctors would likely be more available. Defensive medicine would decrease. More importantly, it could stem the rise in insurance premiums that have led hospitals and obstetricians to stop delivering babies.
What I write here is not offered as a comprehensive plan to fix all aspects of our healthcare system. They are simply effective places to start. These ideas do not ration care or reduce access to specialists or require radical reform.
Certainly, we should have an extensive and comprehensive dialogue about what may be the broad health reform that many envision. That should not stop us from doing things now that may even contribute to the ultimate grand health reform.
Herbert Pardes, a physician, is president and CEO of NewYork-Presbyterian Healthcare System.