Public health pioneer and onetime Centers for Medicare & Medicaid Services chief Dr. Donald Berwick unveiled a 6-step plan to cut waste in U.S. health care spending.
The U.S. spends 17% of its gross domestic product on health care services, a figure that he estimates may reach 20% soon, and Berwick worries that as much as ⅓ of that may be driven by waste.
"Because of my 30 years of work on quality improvement, I know that the best way to reduce costs is to improve quality – not to cut back on care," Berwick told the Journal of the American Medical Assn.’s JAMA Report. "If we don’t work on waste and improvement of care as the fundamental agenda for reduction of cost, we’re headed over a cliff. Bad things are going to happen."
At a Pioneer Institute presentation in Boston last week, Berwick maintained that health care is human right and said he’s eager to see the day when everyone has access, but added that the U.S. system wastes far too much money.
"There’s no discoverable relationship between the amount of money you spend and the quality of health care," he said. "Most of the areas that are spending the most have worse quality of care. It hints at waste."
Rather than make changes to health care eligibility and benefit structures, Berwick suggested 6 steps to reduce wasteful spending, including:
- Cutting down on medical errors, such as "a post-operative complication that could have been avoided or an infection that someone gets or a medication mishap,"
- coordinating care to ensure that providers don’t "drop the ball when you go from a primary care dotor to a specialist or from hospital to home,"
- putting a stop to overtreatment with drugs, devices and interventions that don’t do much good,
- reducing the onerous amount of administrative paperwork surrounding medicine,
- addressing pricing failures through which diagnostic procedures such as MRIs and CT scans might cost several times more in the U.S. than abroad,
- and stemming fraud and abuse in the health care system.
"The opportunity for rescuing health care from this terrible cost crisis we’re in is enormous through the reduction of waste, and we can do that without harming a hair on any patient’s head," Berwick said.
