I just had lunch with Michael Dukakis (and 20 other people). Dukakis, the 1988 US presidential candidate, is a lifelong Bostonian and teaches at Northeastern University. Tom Hopcroft, president of the New England Business and Technology Association, persuaded him to join our leadership luncheon series, with a change in focus from leadership to health care. Most of the people in the room were from Boston health care industry companies–hospitals and medical research are big business here. Dukakis explained that his big concern is the cost of health care in Massachusetts: we are the most expensive state in the most expensive nation in the world, when it comes to the costs of health treatment.
What astonished me was the sense of helplessness people seem to feel about a crisis in what Anna Sabasteanski pointed out is a basic human right in other advanced nations. Can it be true that we don’t really know where the money is going, and exactly how our spending differs from that of other countries (and even other states)?
Dukakis proposed that NEBATA companies collaborate in a document setting out how information technology could be configured to improve our health system, and save money. Ironically, some of the technology people there (though not those from health care companies!) were vehement in saying that technology wasn’t the solution. What struck me is that we need both leadership and effective cooperation to solve a problem that is social, economic, and political.
I asked where the money was going and, sadly, got a vague answer from Dukakis. But a quick web search provided this information: “One important difference between costs of care in the United States and those in other developed nations is the price per unit of careâ€”physician fees, payments per hospital day, and pharmaceutical prices (10, 11). Even though the United States does not provide a greater quantity of physician visits per capita than other nations, physician income is 3 times higher in the United States than in the average nation that belongs to the Organisation for Economic Co-operation and Development. The ratio of average physician income to average employee compensation is 5.5 in the United States compared to 1.5 in the United Kingdom and Sweden (11). Physicians in the United States receive higher fees (prices) for similar services than do physicians in other nations (11, 12).” from “High and Rising Health Care Costs. Part 3: The Role of Health Care Providers” at the Annals of Internal Medicine.
And, if you can access it through your library, the article Dukakis referred us to: “U.S. Health Care Spending In An International Context.”