News and media around the world are focused on Luigi Mangione and the United Healthcare CEO shooting; why are they failing to put the spotlight on the subject matter at the epicenter of this incident: the healthcare cost crisis?
Americaās healthcare system is in trouble. Youāve heard it before, havenāt you? The headlines scream, the numbers shock, and yet here we are again. The Wall Street Journal recently laid it bare: healthcare spending is up 7.5% this year, reaching an eye-watering $4.867 trillion. Thatās $14,570 for every man, woman, and child. Itās a staggering number, one that should stop us in our tracks. But does it? Or are we so used to the idea of spiraling costs that we just sigh and move on?
Hereās the thing: this isnāt sustainable. Hospital costs are soaring, chronic diseases are draining wallets, and individual Americans are buckling under the weight of ever-rising premiums and deductibles. We know the problems. Weāve seen the numbers. But what about the solutions?
Thereās an idea worth paying attention toāvalue-based care (VBC). Itās a shift, a rethink, a move from paying for how much care you get, to paying for how good that care is. Itās not just a tweak to the system; itās a philosophy, a new way of thinking about what healthcare should do and how it should do it.
Letās start with hospitals, those massive institutions we depend on but rarely think about until weāre wheeled into one. Spending on hospital care is rising at its fastest pace in over 30 years. Labor shortages, consolidations, inefficienciesāitās all adding up. And who pays for that? You do. We all do.
Value-based care offers a way to change this. Imagine if hospitals were rewarded not for how many patients they churn through but for how many patients they help stay healthy and out of the hospital in the first place. Preventive care isnāt just a buzzword; itās a game-changer.
Care coordination, for example, ensures patients donāt fall through the cracks after being discharged. No more unnecessary readmissions because someone forgot to schedule a follow-up. And then thereās the idea of hospital-at-home care, where patients receive acute care in their living rooms instead of in a hospital bed. Itās cheaper, itās more comfortable, andāget thisāit works.
Then there are the chronic diseasesādiabetes, obesityāthe conditions that sneak up on you and stick around. The Journal points out that spending on medications for these diseases is climbing fast, and itās no surprise. These are conditions that require daily management, often expensive management.
But what if we stopped focusing solely on treatment and started focusing on prevention? Value-based care does just that. Providers are incentivized to help patients manage their weight, their diets, their lives. Itās not just about prescribing insulin; itās about helping someone never need it in the first place.
And letās talk about drug pricing. In a value-based care system, pharmaceutical companies donāt just sell a drug and move on. Instead, the price is tied to results. If a medication doesnāt deliver better health outcomes, why should it command top dollar? Itās a radical idea, but itās also a common-sense one.
Finally, thereās the cost to you, the individual. Premiums are up. Deductibles are up. It feels like no matter how much you pay, youāre always paying more.
Value-based care has an answer here, too. By focusing on efficiency and quality, it can lower costs across the board. Bundled payments, for instance, offer predictability. Instead of paying for every little thingāan X-ray here, a blood test thereāyou pay a single fee for an entire course of treatment. Itās simpler, itās clearer, and it saves money.
And then thereās the idea of shared savings. When providers save money by being more efficient, those savings can be passed on to you. Itās a system that rewards everyone, not just the biggest players.
Value-based care isnāt just about fixing the numbers. Itās about rethinking what healthcare is for. Right now, it often feels like a machine, churning through patients and dollars with little regard for the outcome. Value-based care says, āWait a minute. What if the goal was to make people healthier, not just treat their illnesses?ā
The Wall Street Journalās report (you can read it here) paints a bleak picture of the current system. But it doesnāt have to stay this way. We can do better. We must do better.
This isnāt just a policy debate; itās a moral one. How we care for each other, how we ensure that every dollar spent in the system does the most goodāthese are questions we need to answer.
Value-based care doesnāt solve everything, but itās a step in the right direction. Itās a shift toward a system that works for people, not just profit margins.
And isnāt that the kind of healthcare we all want?