<br><br><div class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br>crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p style="margin-left: 0.5in;"><b><font color="maroon" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: maroon; font-weight: bold;">High and rising health care costs: Demystifying U.S. health
care spending</span></font></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Paul B. Ginsburg, President, Center for Studying Health System
Change</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy; font-weight: bold;">THE SYNTHESIS PROJECT - RESEARCH SYNTHESIS REPORT
NO. 16 - OCTOBER 2008</span></font></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Available online as PDF
file [32p.] at: <a href="http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.rpt.pdf" target="_blank"><font color="navy"><span style="color: navy;">http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.rpt.pdf</span></font></a>
</span></font></p>
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<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Why is this issue
important to policy-makers?</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- In 2006, the United States
spent $2.1 trillion, or 16 percent of gross domestic product (GDP), on health
care. <br>
This translates to $7,026 per person annually </span></font><font color="navy" face="Arial" size="1"><span style="font-size: 8pt; font-family: Arial; color: navy;"> (Reference 1).</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- U.S. spending on health
care is greater than that of any other developed country, yet unlike other
countries, which provide near-universal coverage, <br>
16 percent of Americans are uninsured </span></font><font color="navy" face="Arial" size="1"><span style="font-size: 8pt; font-family: Arial; color: navy;">(Reference 2).</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- Without steps to
restrain growth, increases in health care spending will eventually consume almost
the entire GDP.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Policy-makers have a number
of options available to restrain health care spending growth, none of which are
easy. With research consistently showing that medical technology is the largest
cost driver, applying technology more selectively to patients needs to be an
element of any long-term approach. </span></font></p>
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<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">To accomplish this,
policy-makers could:</span></font></p>
<p style="margin-left: 75pt; text-indent: -0.25in;"><font color="navy" face="Symbol" size="2"><span style="font-size: 10pt; font-family: Symbol; color: navy;"><span>·<font face="Times New Roman" size="1"><span>
</span></font></span></span></font><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Increase
funding for research on effectiveness. This is the beginning of an approach
that supports the appropriate application of medical technology to the patients
likely to receive the highest benefit.</span></font></p>
<p style="margin-left: 75pt; text-indent: -0.25in;"><font color="navy" face="Symbol" size="2"><span style="font-size: 10pt; font-family: Symbol; color: navy;"><span>·<font face="Times New Roman" size="1"><span>
</span></font></span></span></font><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Reform
provider payment systems. Distortions between payments and costs of services
lead to undesirable provider incentives to emphasize the most profitable
services. These unintended incentives tend to favor services incorporating new
technologies.</span></font></p>
<p style="margin-left: 75pt; text-indent: -0.25in;"><font color="navy" face="Symbol" size="2"><span style="font-size: 10pt; font-family: Symbol; color: navy;"><span>·<font face="Times New Roman" size="1"><span>
</span></font></span></span></font><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Increase
use of consumer financial incentives and support. To the degree that consumers
bear some of the financial risk of medical spending, they are likely to be
judicious concerning the use of technologies with low value to them as
patients. For this to work as intended, however, patients must be provided
information on treatment alternatives and their effectiveness, and on the
quality of different providers of care, and must face incentives to favor more
effi cient providers. Use of this approach is limited by the need to maintain
adequate financial protection for the costs of illness or injury.</span></font></p>
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<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Content: </span></font></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- Introduction</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- Findings</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- Implications for
Policy-Makers</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- The Need for Additional
Information</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">- Appendix I References</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">Policy brief: <a href="http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.brief.pdf" target="_blank"><font color="navy"><span style="color: navy;">http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.brief.pdf</span></font></a></span></font><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 1in;"><b><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy; font-weight: bold;"> </span></font></b></p>
<p style="margin-left: 1in;"><b><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy; font-weight: bold;"> </span></font></b></p></div></div></div><br>