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Tags: health care

Simple Fix for Healthcare: Give Patients More Responsibility

medications syringes and a medical mask on top of fanned out one hundred dollar bills
(Dreamstime)

Sally Pipes By Monday, 24 October 2022 10:30 AM EDT Current | Bio | Archive

Health costs have been rising at an astounding rate. Insurers believe that overuse of medical care and poor individual health habits are big reasons why, according to a new study from insurance advisory firm Willis Towers Watson.

That conclusion runs counter to the narrative common among progressives that patients are hapless victims of a profit-driven health care system. There's plenty of evidence showing that individual choices deserve more of the blame for the steady rise in U.S. health costs.

Critics of the U.S. system often complain that, despite spending more than any country on health care, America has some of the worst outcomes. And they have a point.

In 2020, health care spending grew by nearly 10% over the previous year, reaching $4.1 trillion, or $12,530 per patient. Switzerland, the country with the second-highest per capita health expenditures, spent roughly $5,000 less.

Those high expenditures don't appear to be buying Americans extra years of life. U.S. life expectancy has declined in recent years and is well below that of other developed countries.

But it's a mistake to suggest that high costs and poor outcomes are an inevitable result of our health system. And that's because, in a great many cases, the lifestyle choices of individual patients are the culprit.

By one estimate, over 42% of adults in this country are obese, and over 9% are severely obese. Deaths from drug overdose rose by 30% in 2020 and another 15% in 2021.

Alcohol abuse rates have been rising steadily for years among many demographic groups. And according to the Centers for Disease Control and Prevention, more than 15% of adults are physically inactive, engaging in no "leisure-time physical activities."

Given the prevalence of these unhealthy behaviors, is it any wonder America spends so much on health care, or that the nation's health outcomes are poorer than our peers'?

This reality hasn't escaped the notice of insurers. According to the Willis Towers Watson study, over half of insurers point to poor health habits as a major cause of high health care costs.

It's also notable that 75% of insurers believe overuse of medical care is a serious source of health care inflation — up from 64% last year.

It's tempting to blame providers for this second problem, as doctors are the ones ordering tests and prescribing treatment. But here, too, patients bear some of the responsibility.

Consider the "better safe than sorry" philosophy patients often adopt regarding medical care. This can take many forms, such as requesting antibiotics as a precaution, regardless of whether one's condition warrants the treatment.

It's also not uncommon for patients to seek tests, not to identify their illness, but to discover if they're sick at all.

Insisting on high-tech testing techniques like an MRI scan over less sophisticated alternatives is yet another example of this maximalist attitude toward testing.

Providers sometimes employ a "better safe than sorry" philosophy, too. They worry about being sued for medical malpractice. Ordering that extra test could immunize them from a lawsuit claiming negligence.

The annual cost of such defensive medicine is in the tens of billions of dollars.

Americans with insurance often pay little to nothing for marginal tests and procedures. Their health plans pick up the tab. So they're largely insensitive to costs — not just the financial costs of their care but the costs their lifestyles exact on their health.

We can address this dysfunction — and give patients a greater incentive to take care of themselves — by putting them in charge of their health care spending. Third-party payers like insurers have little incentive to promote good health among their beneficiaries; it's easier to just raise premiums, which employers typically pay.

If patients had responsibility for their own health care dollars, they'd seriously consider whether a marginal test or procedure is worth the cost. And because they'd keep whatever they didn't spend, they'd have a strong incentive to mind their health.

The U.S. health care system's high costs are largely a function of the preferences — and needs — of the patients it serves. If we want costs to come down, we'll need to deputize patients to make that happen by giving them responsibility for more of their own health care.

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.

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SallyPipes
Health costs have been rising at an astounding rate. Insurers believe that overuse of medical care and poor individual health habits are big reasons why, according to a new study from insurance advisory firm Willis Towers Watson.
health care
751
2022-30-24
Monday, 24 October 2022 10:30 AM
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