Another Voice / Health coverage
Cost of delivering care threatens a medical meltdown
The health care industry in the United States displays many of the same symptoms that the housing industry did before the bubble broke, and it is not immune from an analogous downturn.
Spending on health care is rising 6 percent to 7 percent per year, more than twice the rate of inflation, just as housing prices rose. The Department of Health and Human Services Centers for Medicare and Medicaid Services project that 20 percent of our gross domestic product will be spent on health care by 2017. This number was 5.1 percent in 1963.
The unfunded liability in the Medicare program dwarfs that of Social Security, and is estimated at $60 trillion over the next decades — $200,000 per person. Like a mortgage that a borrower cannot afford, this obligation is a mortgage that the nation cannot afford.
Much planning for economic development, including that for Western New York, implicitly assumes that the expansion of health care spending will continue, that dollars will be available to pay for new therapeutics and diagnostics, and for implementing the exciting, new paradigm of individualized medical care. But clearly this assumption is under threat. How should we adjust our thinking about economic growth through health care delivery to take advantage of these realities rather than to be set back by them?
An example of such targeting is the proposal, developed as part of the University at Buffalo 2020 initiative, to develop a model Center for Health and Wellness Across the Life Span. This center would promote a broad view of aging and chronic disease. A range of disciplines, from the biomedical and social sciences to economics, law and architecture, would be brought to bear.
The UB proposal states in part: “at the core of this strength is the development of the Western New York community as a ‘living laboratory’ for the development and testing of new interventions and the measurement of their impact on disease, health and wellness of the region.”
This broadly conceived initiative has the right idea. However, even it does not fully contemplate the reality of limited resources. It seems to me that our portfolio needs to include both research into, and implementation of, technologies and practices that will radically reduce the cost of delivering top-notch health care. Target areas include electronic patient records, imaginative new public health measures, reinventing vaccine technology and radical interventions for addictive behavior.
By no means are we making a mistake in supporting medical research at institutions like UB, Roswell Park Cancer Institute or at innovative small companies like SmartPill or Kinex. But we need to balance this with research emphasizing cost reduction. We would thereby be contributing to sustainable health care, just as we want to contribute to a sustainable environment.
Eaton E. Lattman is CEO of the Hauptman- Woodward Medical Research Institute in Buffalo.
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