The recent report from the Department of Labor showing that the United States economy added just 69,000 jobs in May was met with surprise and disappointment and has had an immediate effect on the presidential campaign as well as the stock market.
What was lost in this news, however, is that almost half of the job growth came in the health care sector. Thus, health care provides a large underpinning for our economic growth, but is this a good thing? Currently, health care expenditures are quickly increasing beyond what individuals, employers, or the government can afford. Ironically, what is gained by these increases in employment may be offset by the burden of rising health care costs on the overall economy. This raises an important question. Is the expansion within the health care industry a good thing for our economy and nation or is it an emerging bubble that will inevitably burst?
Over the past decade, national health care costs grew from an already large $1.6 trillion per year and 14% of the GDP in 2002 to $2.6 trillion per year and 18% of the GDP currently. This growth has been fueled by increased costs of treating chronic diseases with expensive specialty and hospital care. Such expenses are driven in part by investments in technologies and new facilities which often rival the opulence of five star hotels. According to the Health Care Cost Institute, price increases and costs of hospital admissions grew nearly three times faster than inflation. Despite the drag on the economy from the rising cost of health care, preventable chronic diseases have continued to grow. Consequently, the increased expenditures have not led to an improvement in the health of the nation.
What is frightening is the parallel between the growth in the health care industry and the recent experience in the real estate market. In real estate, the American dream to own a home was seen as laudable. Unfortunately, the financial market could not sustain the growth of the housing market and it ultimately collapsed. In health care, access for all Americans is at least as important a goal and should be achieved, but it must be done in a way that is effective and affordable. The current approach, in my view, is neither effective nor sustainable. Fortunately, there is a solution to this dilemma. Health care expenditures must be focused toward health promotion, prevention, patient engagement, and coordinated care rather than the current emphasis on high cost, sporadic treatment of disease events which are largely preventable. We know how to make the approach to care far more effective and less costly.
Personalized, predictive, and preventive approaches, with intense patient engagement, are already proving to be far more effective than the current reactive treatment of disease events. At the center of effective care should be the individual (who at times is the patient) who is engaged, informed, and involved in their own health. Coupling the engaged individual with a health care system designed to meet personalized medical needs overtime is the model that we should move toward. Health care sector growth within a system that actually improves health and minimizes preventable diseases will be cost effective, sustainable, and a true boost to our economy. Absent this, growth in the health care industry is a mixed blessing.
Welcome to the Blog of the Duke Center for Research on Prospective Health Care
The mission of the Duke Center for Research on Prospective Health Care is to support the development and implementation of prospective health care, a personalized, predictive, preventive and participatory approach to care that is based on the integration of three key elements: (1) personalized health planning, (2) coordination of care, and (3) rational reimbursement. On this blog we discuss current issues in prospective health care and personalized medicine, including ongoing research and outreach in the Center, the work of other leaders in the field, and innovations in science and technology that can promote this model of care. We invite you to this important conversation and look forward to your thoughtful comments and ideas.
The views, opinions and positions expressed by the authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Duke's Center for Research on Personalized Health Care.