An Economist's Perspective on How to Improve Healthcare

Read Transcript

The most prevalent problem is that people, the patient is the most underutilized resource in the US health system. People don't take care of themselves, they don't engage with themselves, with their doctors, with their families, with their communities and healthcare. We have all the technology in the world per capita, more than we really need in terms of ORs and MRIs CT scanners, gamma rays et cetera.

What we don't have is, patient -person participation in their own health. You can slip sensors on anything, now sensors have gotten very cheap and so sensors themselves, the sensor technology will not be the problem. What will be the problem is making sense out of sensors, sense making.

So you'll have all these data points potentially about somebody but unless we have a way to coral that data and make it picturable, graphic and understandable to people, let alone doctors who don't want to be flooded with a million data points on a single patient. We have to create ways, to final it, so that we get the most important sensitive data, those meaningful data and then be able to analyze it very quickly, very nimbly.

So that we get to the core of what is really important and my fear is, that we are all going to be such conified selves, that we are not going to be able to make sense, out of all these data points. The potential for mobile health in general is huge, because health is our search sense is where we live, work, play and pray, it's largely outside of the doctors office.

So if we can have an app that helps us do the right things through the day, choose the right foods to eat, take the extra steps through the day, take our medications, that does move the need on personal behavior, bolsters could help behavior and then out comes and drives costs out of the system.

The work flow of how a physician shuffles papers and moves from a paper based environment to the digital environment. How an insurance company moves from that cheque paying environment, to direct deposit kind of environment. So, all of these players in the eco system have to move away from paper and will save some waste money that way as well, that's not a panacea but it's part of the needle moving challenge.

Apps aren't as well designed as they need to be, I think people would like them to be because they download them, but they're just not fun, so a lot of this involves and I used the word designed several times in that conversation. We need to make health a lot more fun and engaging than it's been.

There's a theory called consumer directed health care which means putting consumers with more skin in the game, paying more out of pocket, paying more on premiums, that's supposed to in theory, get people to pay better attention to health, in this early pioneering stage of consumer doctor directed healthcare, it hasn't worked.

We have to design heath plans much more artfully than we've done in the past. Thinking about how people actually think about healthcare, as a consumer not as a patient. So I believe in paying a primary care for a physician and then turn this to a family precautionary paediatrician, and OPG run more than we pay brain surgeons relative to what we pay brain surgeons today.

Primary care is tremendously underfunded and that's why a primary care doctor has to speed up the visit from between 3 and 7 minutes versus what should be a 30 minute visit, at least once a year.