Rising Health Care Costs

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Submitted on Mon, 01/02/2017 - 00:00

There has been great attention by the media about rising health care costs in the United States. It is frequently cited that our outcomes are in many areas worse than those of countries where health care expenditures are significantly less.

Health care costs in the US are higher, but there are many plausible explanations. End-of-life care in the US is not rationed and it accounts for a disproportionate fraction of costs. Medications and devices are sold at a much higher price in the US than in most parts of the world even though many of those are made in the US. Fear of malpractice litigation results in defensive medical practice resulting in overutilization of testing. Higher infant mortality is often cited as a failure in our health care, but this has far more relationship to maternal  practices prior to delivery than actual health care. Higher infant mortality is noted when there is drug abuse and malnutrition. These are just a few of the potential explanations. Nothing has been done to significantly address these issues.

In response to combat the rising health care costs without clear demonstrable clinical benefit there have been mandates from the government including the requirement of utilization of electronic medical records. These EMRs are touted as a means of improving care and decreasing costs. I am skeptical about the impact of these EMRs. Our relatively small hospital will incur direct costs of approximately $50,000,000 next year alone without including indirect costs such as training implementation and decreased workflow. I’m also concerned about patient information security given the multiple reported security breeches that have occurred even within supposedly secure governmental servers.

I would like to know your opinions as to whether or not this forced EMR implementation will ultimately result in cost savings.