$1 in $3 in health spending goes to clinical waste

In a meeting yesterday in Boston, I was reminded by the CEO of Blue Cross and Blue Shield of Massachusetts, Cleve Killingsworth, the great work of the New England Healthcare Institute (NEHI) on clinical waste.

NEHI's magnum opus on clinical waste shines a light on hundreds of studies which illustrate standards of care that, goether, could eliminate the 30% of health spending that is clinically wasteful and often deleterious to Americans' health. These include using beta-blockers for patients with high blood pressure, measuring hemoglobin A1c for diabetics, among the many other evidence-based health tactics.

The definition of "clinical waste" = overuse, underuse, misuse, and medical errors. Much of this was documented in the seminal book, Overtreated by Shannon Brownlee.

Cleve asked the rhetorical question: "How many purchasers buy 30% waste?”

Heatlh Populi's Hot Points: When it comes to Medicare and Medicaid, the 'purchasers' are, ultimately, U.S. taxpayers who foot the bill for public health programs every April 15th and throughout the year in tax withholds from ever-shrinking paychecks.

How to get to the root of waste: pay for evidence-based care, the details of which are provided in the NEHI's compendium of peer-reviewed evidence covering over 400 sources.

Health reform proponents, know this: adding people who are uninsured to a health system that currently pays for wasteful care not only wastes money, but brings people sub-optimal health care in the form of higher morbidity, mortality and medical errors. Health reform must include payment reform or it won't only not bend the cost curve -- it will continue to endanger the lives of health citizens.