Health care trends

Stumbled on some notes I took several months ago when some of the most prominent medical leaders in Cleveland all came together on a panel and actually answered questions from the audience. Fred C. Rothstein, MD President and Chief Executive Officer,
University Hospitals of Cleveland, talked about trends:

  • Diseases will spread through many countries with the decline in the effectiveness of antibiotics
  • One-fifth of U.S. citizens will be growing older.
  • The population will double within the next generation.
  • Fifteen chronic conditions will constitute 80% of health care costs in the U.S.
  • By 2020, there will only be two people working for every person who is retired. Now, more people are taking care of aging parents than are taking care of children.
  • Some companies (he mentioned Lucent) are phasing out retirement benefits.
  • Diagnostics will improve (in vitro, imaging, etc.). Treatments will be tailored to the individual’s disposition and symptoms. Focus will be on prevention. molecular intervention, and lifestyle modification.

Costs for end-of-life care are 10-12% of the country’s total health care budget–27% of Medicare. One-third of Medicare spending is in the last year of lilfe–40% of it in the last 30 days of life. Hospice care can save 25 to 40% in health care costs.

I once stumbled on a television interview in which the speaker said more and more people in America will have to be working until they are 80 years old. Of course, that would be those who manage to live that long. It comes down to this: the time-honored American dream of retirement is heading the way of the fully-paid-medical-benefits-for-everybody phenomenon–into ancient history.

I asked what would stop the outrageously upward spiral of health care in America–his answer was: when people start having to pay for it themselves. Well, we’re getting there quickly. Fortunately, getting funding for research doesn’t depend on how much is spent on health care delivery. With the dramatic advances being made in stem cell therapies, genetics, and other areas, we have good reason to feel hope that a lot of healing will soon become not only cheaper but also much more natural and less intrusive.

So, okay. Even if we can’t retire, science is every day finding ways to help us live a better quality of life until the day we do have to go.