How to Reduce Healthcare Spending and Improve Health at the Same Time

Healtcare SpendingWith the annual cost of health care about to consume 4 trillion dollars annually in the US in the next 10 years and our $300 billion spent each year on pharmaceuticals (equal to the rest of the world combined) we have a health system out of control that is actually making us sicker by the year. 

In pediatrics in particular, we have mandated vaccines that are not just unnecessary (Hep B to newborns of non-infected moms) but dangerous!  Each newborn in the USA gets 250 micrograms of aluminum with their Hep B vaccine at birth and again at 2 months, 4 months, and 6 months. To make sure our country’s children continue to get poisoned by this vaccine (others have issues too), pediatricians are rated on their quality of care and if you have a poor immunization rate, this is the equivalent of you being a bad doctor.  With some insurance companies, this carries a financial penalty, and puts a financial incentive to do the wrong thing. Other insurance companies reserve the right to drop you from their provider panel if you rate poorly in health quality measures.  With vaccinations, it’s all or none when it comes to their determination of “quality”. Educated parents who wish to selectively vaccinate given the unique risk factors for their family, would be frowned upon as making a poor decision if you are not giving all the vaccines at the recommended times.

Findings from a National Research Council/Institute of Medicine Report show that the US spends more on health care than does any other country, but our health outcomes are generally getting worse than those of other wealthy nations.  We have more disease and die younger and the disadvantage has been increasing for decades.  We have shorter life expectancies than 16 other countries like Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom.  Access to health care is a big factor.  Wealth in the US is not evenly distributed, meaning that more of our population is poor and has poor access to health care.  I would add that the nature of our health care, dominated by pharmaceutical influence, has also had a negative effect on wellness and life-span.

It is time that consumers start using their health dollars wisely.  This will take a creative, thoughtful approach.  I would propose we keep health insurance for catastrophic illness and accidental injury and put the rest of the health dollars toward real prevention and healthy life-style approaches.  If a typical cost to care for a child is $1000/ month then put $300 to health insurance that just covers catastrophic expenses (eg $5,000 deductible for the year) and the additional $700/ month can be pooled for covering expenses that truly improve health (selected vaccines, selected nutritional supplements like Vit D, probiotics, fish oil, and a good multivitamin, and programs that promote good nutrition and exercise, reduced TV viewing, etc.)

I propose rating physicians on how well they utilize health care dollars, looking at real outcomes like dollars spent in ER care, with specialists, and total dollars spent per member per year, not the arbitrary goals set to maintain the status quo for vaccines or well child care visits. Pediatricians are now also being rated on the number of well child visits done in the first two years of life.  I have found that well visits at 2 weeks, 2, 4, 6, 9, 12 and 18 months to be more than adequate (if not excessive) to pick up any health problem.  The AAP (Academy of Pediatrics) and insurance companies want us to do a 15 months visit as well. We are being rated on what percentages of our 2 year olds have ALL the vaccines. Well, if your patients are educated on the real need for Hepatitis B vaccine, and that it has 250 micrograms of aluminum (adult daily maximum is 50 micrograms) they rarely choose to give that one to newborns and in the first two years of life.  One catches Hepatitis B from sex and IV drug use.   

It seems spending more on these costly well-visits and vaccines equates to better health care in their minds.  I’m proposing we encourage all of our families and patients get their complete genetic profile for SNP’s (Single Nucleotide Polymorphism) from 23andme, selectively vaccinate for the conditions for which their children are at risk, and spend less on well child visits and more on healthy diets, life-style, and supplementing nutritional deficiencies.

All we need is for a moderate to large company to embrace such an approach and demonstrate the improved health outcomes, and huge cost savings.  This would take courage to go against the status quo.  As an individual, however, we can begin this journey with a new program being pioneered here, at Integrative Pediatrics.  This program is all about education, informed consent, knowing your genetics and nutritional deficiencies and food sensitivities.  Everyone should be taking vitamin D from pre-conception through pregnancy and on.

You can order your 23andme kit (only requires spit and $99 plus shipping) at www.23andme.com

(I have no affiliation with 23andme – just impressed with the comprehensive and valuable data for the price).

 

Dr. Paul 

 

 

 

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