The way healthcare is discussed often frames it as an impersonal thing we need to do something about. Make it more affordable. Simplify it. Eliminate surprises.
However, there is no greater personal connection in our lives than the connection we have to health and care. We all want to be healthy and we want the highest quality care when we aren’t healthy. Our children and our future generations deserve our best thinking. By working together, patients, healthcare providers, communities and the private sector, including employers and health service companies, can create a more sustainable system that delivers.
The most critical and immediate healthcare challenge that American families face today is rapidly escalating costs—which continue to grow at an unsustainable rate.
Healthcare spending is projected to rise more than 5% annually over the next decade and account for about one-fifth of the U.S. economy. Moreover, the U.S. spends more on healthcare per capita than any other nation in the Organisation for Economic Co-operation and Development; yet, U.S. life expectancy is increasing at a slower pace than in most of them (rising only slightly in 2018 after four straight years of decreases).
Three key factors have set the U.S. healthcare system on its unsustainable trajectory.
The first is that we have built a system that largely intervenes—medically and with pharmaceuticals—only once people are sick. That’s too late. We need to start earlier to support people in adopting and maintaining healthy behaviors to keep people healthier longer.
The second is the rise of chronic disease and declining health. Today, nearly half of all Americans suffer from at least one chronic disease, and the number is growing. Costs associated with heart disease, cancer, diabetes, and Alzheimer’s disease totaled slightly more than $1 trillion in 2016. And, when lost economic productivity is included, the total economic impact is approximately $3.7 trillion.
And third is healthcare waste, which is most often the result of poor care coordination, unnecessary treatments, unnecessary hospital readmission, and avoidable complications. Annual healthcare waste accounts for 25% of total healthcare spending, with estimates ranging from $760 billion to $935 billion. In Medicare alone, more than $23 billion of improper payments were made due to errors in 2017.
For those three reasons, and many more, it’s time for a new wave of transformative change that makes healthcare more affordable, predicable and simple for all Americans.
This is not a far-fetched dream. It’s being done already—largely in pockets of the employer-sponsored market and Medicare Advantage. We can and must do more.
The most successful programs, or the “bright spots,” have three basic elements:
- They are innovative and constantly evolving to meet the changing and diverse needs of individuals;
- They recognize the important role that the private sector and the government have in creating a sustainable healthcare system; and,
- They act as tight-knit communities that support, encourage and incentivize adoption of healthy behaviors and healthcare consumerism.
In a transformed healthcare system, the quality of life will increase and healthcare costs will decrease as innovative programs and solutions are built to address the health needs of today and prevent the health burdens of tomorrow. Data and technology will create a more connected system that closes gaps in care and eliminates waste. The healthcare experience will be as convenient and personalized for individuals as it is in other industries. And, healthcare providers will be rewarded for delivering the best services.
At Cigna we believe that changing the debate in healthcare from who pays for sickness—to how we systematically replicate the bright spots in healthcare—is essential to give Americans a healthcare system that works for them, not the other way around.
Health and care shouldn’t be two words we just mash together. They need to be the guiding principles that accelerate the transformative changes our country needs.