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What’s Driving Health Care Costs?
http://masscare.org
Universal, Affordable Care for Massachusetts
U.S. Spends Almost Double Next Highest Spending Country
Common Explanations for High Health Care Costs
• Inadequate Prevention • Behavioral factors
– High obesity rate – High smoking rate – High levels of drinking
• Racial and Ethnic Makeup of the U.S. • Aging population • End of life care • Chronic Illnesses
– High cancer rates – High diabetes rates – High heart disease rates
• Overuse of technology (e.g. MRIs, CT scans, etc)
• Use more prescription drugs
• Fee-for-service: overuse of tests and procedures
• Lower cost transparency • More third party insurance payers • More physician visits • More ER and hospitals visits • More Medical Malpractice lawsuits • Worse electronic health records • Higher Cost of drugs • Higher cost of medical devices • Too much hospital bargaining power • More profits • More administration/paperwork • Higher physician/nurse pay
Common Explanations for High Health Care Costs
• Inadequate Prevention • Behavioral factors
– High obesity rate – High smoking rate – High levels of drinking
• Racial and Ethnic Makeup of the U.S. • Aging population • End of life care • Chronic Illnesses
– High cancer rates – High diabetes rates – High heart disease rates
• Overuse of technology (e.g. MRIs, CT scans, etc)
• Use more prescription drugs
• Fee-for-service: overuse of tests and procedures
• Lower cost transparency • More third party insurance payers • More physician visits • More ER and hospitals visits • More Medical Malpractice lawsuits • Worse electronic health records • Higher Cost of drugs • Higher cost of medical devices • Too much hospital bargaining power • More profits • More administration/paperwork • Higher physician/nurse pay
Common Explanations for High Health Care Costs
• Inadequate Prevention • Behavioral factors
– High obesity rate – High smoking rate – High levels of drinking
• Racial and Ethnic Makeup of the U.S. • Aging population • End of life care • Chronic Illnesses
– High cancer rates – High diabetes rates – High heart disease rates
• Overuse of technology (e.g. MRIs, CT scans, etc)
• Use more prescription drugs
• Fee-for-service: overuse of tests and procedures
• Lower cost transparency • More third party insurance payers • More physician visits • More ER and hospitals visits • More Medical Malpractice lawsuits • Worse electronic health records • Higher Cost of drugs • Higher cost of medical devices • Too much hospital bargaining power • More profits • More administration/paperwork • Higher physician/nurse pay
Common Explanations for High Health Care Costs
• Inadequate Prevention • Behavioral factors
– High obesity rate – High smoking rate – High levels of drinking
• Racial and Ethnic Makeup of the U.S. • Aging population • End of life care • Chronic Illnesses
– High cancer rates – High diabetes rates – High heart disease rates
• Overuse of technology (e.g. MRIs, CT scans, etc)
• Use more prescription drugs
• Fee-for-service: overuse of tests and procedures
• Lower cost transparency • More third party insurance payers • More physician visits • More ER and hospitals visits • More Medical Malpractice lawsuits • Worse electronic health records • Higher cost of drugs • Higher cost of medical devices • Too much hospital bargaining power • More profits • More administration/paperwork • Higher physician/nurse pay
Disease Prevalence: U.S. vs. Peer Countries
95%
106%
105%
98%
67%
77%
122%
86%
91%
97%
0% 20% 40% 60% 80% 100% 120% 140%
Heart conditions
Trauma-related disorders
Cancer
Mental disorders
COPD, asthma
Hypertension
Diabetes melitus
Osteoarthritis/joint disorders
Back problems
Other
Disease Prevalence: U.S. vs. Peer Countries
95%
106%
105%
98%
67%
77%
122%
86%
91%
97%
0% 20% 40% 60% 80% 100% 120% 140%
Heart conditions
Trauma-related disorders
Cancer
Mental disorders
COPD, asthma
Hypertension
Diabetes melitus
Osteoarthritis/joint disorders
Back problems
Other
Disease prevalence
= $57 to $70
billion savings
2.7
6.5 5.5
4.6
6.9
8.2
13.2
5.7
4.3
2.9 4
5
0
2
4
6
8
10
12
14
Physician Visits Per Capita, 2009
131
162
84
170
263 237
117 142
177 166 168
138
0
50
100
150
200
250
300
Hospital Stays per 1,000 population, 2009
5.4 5.9
7.7
5.2
7.5
5.6 5.9
4.6 4.5
7.5 6.8
0
1
2
3
4
5
6
7
8
9
Average Length of Hospital Stay in Days, 2009
Nations With Universal Health Care Coverage
How Universal Health Care Is Paid For
You Government Fund
Health Care Providers
Fixed Payroll Tax Negotiated Budget
How U.S. Health Care Is Paid For
You Health Care Providers
Medicaid
Tufts Medical Insurance
Blue Cross
Medicare
Out-of-Pocket Costs
Premiums
Taxes Separate contracts
OECD Data, 2010
Insurance Administration Costs
Hospital Administration Costs
OECD, 2010
Brox. et. al. Arch Internal Medicine, 2003
Aortic Aneurysm Repair Costs
U.S. Pays Higher Prices for the Same Drugs
mt.gov.com, 2010