MHALosBanos@SutterHealth.org — >Figures from the Congressional Budget Office show that in 1970, the total combined cost of Social Security, Medicaid, and Medicare was 3.9 percent of GDP (Gross Domestic Product). By 2010, that figure had increased to a little more than10 percent. Projecting these rates of increase out into the next several decades reveals that Social Security will continue to increase slightly, while Medicaid and Medicare costs will skyrocket. By 2049, these three costs will be more than 18 percent of GDP.
What is most alarming is that for decades, tax revenues have fluctuated right around 18 percent of GDP. So, the payouts for the three programs will equal total tax revenue, leaving nothing for other government spending.
A growing doctor shortage and the steadily growing health care cost threaten the quality of life for Americans. The Association of American Medical Colleges forecasts a shortage of nearly 63,000 U.S. doctors by 2015, and 90,000 by 2020. Efforts to trim costs, particularly in Medicare and Medicaid, will only worsen this problem.
The solution to this growing cost issue will be enabled by a combination of deregulation, tort reform, new technologies, and consumer empowerment, forced upon us by dire economic realities. At this time a key element that could improve care and lower cost is innovation, both in new technology and innovative business models.
The biggest factor that will slow the growth of health care costs will be the power of consumers acting in their own interest. Since the beginning of the Great Recession, the rate of health care spending growth has actually declined. This shift is mainly due to a large number of people no longer being insulated from the cost of health care. With people losing coverage through unemployment, or having deductibles raised and coverage trimmed back by cost-conscious employers, people have suddenly become more careful with their medical spending.
Some of this drop in spending has resulted in the cutting of many unnecessary doctor visits and treatments that would have occurred if someone else was paying for them. Also, more patients choose less-expensive generic drugs over name-brands when they have to pay for them directly. Many rural hospitals have closed their doors due to inadequate insurance reimbursements forcing many patients to travel long distances to receive medical services.
Considering limitations on access to timely and affordable health care, individuals need to take more and more responsibility for their own health promotion and disease prevention. Weight management, exercise and more healthy eating habits are becoming more important than ever. The use of para-professionals will replace the traditional doctor-patient interactions, and telemedicine will become commonplace in many health care settings.
Individuals will need to have access to tools and resources with reliable and timely information to make good choices and smart decisions regarding their health. They will need to be their own health care managers relying on consultants such as doctors or physician assistants, nurses, dietitians, pharmacists and others to help them determine what is best for them.
Benjamin Franklin once said, "An ounce of prevention is worth a pound of cure." It was true then, before the advent of antibiotics, x-rays and chemotherapy, and it is true now. Prevention certainly is the best medicine.
Chuck Newcomb, MS, RD, CDE is a consulting Registered Dietitian currently providing medical nutrition therapy services for Memorial Hospital Los Banos. He has a Master of Science in Clinical Nutrition from New York University. E-mail questions to the Attention of ChuckRD at: MHALosBanos@SutterHealth.org or on his website MySmartRD.com. Look for online counseling services coming soon.