You can have a medical emergency anywhere in the U.S. and receive excellent hospital care. That is not the case in other countries, where well-to-do citizens often seek care abroad in the U.S.
Many Americans do the same when travelling ”“ two recent examples: a friend fell and fractured a shoulder while vacationing in Italy ”“ but chose to fly to New York for corrective surgery; another needed emergency abdominal surgery in a popular Mexican resort but received sub-standard care and had to be airlifted to California for life-saving treatment. I just added a credit card air ambulance benefit that will return me to America for care in case of illness abroad.
Many people voice concern that health care costs are “too high.” A federal report shows that in 2011, the average family spent much more on housing ($16,800), transportation ($8,300), food ($6,500) and insurance/pensions ($5,400) than on health care ($3,300), and slightly less on entertainment ($2,600).
But, when our child or parent gets sick, we demand limitless care ”“ “money is no object.” When making health care decisions for our families, we want the best treatment, the most expensive implant and any extra test that could possibly help.
One way other countries reduce health care costs, i.e., quotas on treatments, is not acceptable to most Americans. Restrictions on or delays in receiving care are intolerable. Treatment delays caused one Canadian province to create a “Surgical Wait Times” website. Half of their patients waited more than 107 days for knee replacements and 89 days for hip replacement surgery. A hospital CEO in Buffalo told me about a steady volume of Canadians who paid out-of-pocket for care in upstate hospitals rather than wait months for free care at home.
My friend”™s uncle living in Austria had kidney failure. Life-saving hemodialysis is not made available to 84 year olds there. Fortunately for us, Medicare covers dialysis for people of all ages. America could save a fortune by rationing medical care, but, to me, that is fundamentally wrong. All of us who work in the American health care system want to provide the best possible treatment to every patient.
The federal Affordable Care Act (A.C.A.), a.k.a. Obamacare, presses doctors and hospitals to collaborate to control utilization and improve quality. Simultaneously, the Federal Trade Commission continually blocks both hospital and physician group mergers, including one in Westchester last year.
The single greatest failure of the Affordable Care Act is not addressing Tort Reform. Caps on noneconomic damages in the 13 states without them would save $1.4 billion. Excessive litigation and waste in the current tort system increases health care spending by $124 billion per year, which is enough to cover the uninsured ”“ without harming doctors, hospitals, or patients.
Hospitals successfully do their share to control costs, e.g., shortening inpatient stays, implementing electronic medical records and reducing readmissions. My hospital provided $25 million in charity care and community service in 2012 alone. But, remember that patient care is personal ”“ delivered one patient at a time and is very labor intensive. A simple X-ray requires two different caregivers while surgery requires five staff dedicated to one patient for hours.
Nonetheless, Obamacare extracts tremendous cuts on hospitals ”“ $80 million for my hospital over the next 10n years.
Obese Americans spend 42 percent more on health care than normal-weight Americans. The national cost of obesity, estimated at $147 billion, is substantially avoidable.
In Westchester, 12.3 percent of adults smoke, fewer than the statewide average. But, a recent study reported that smoking employees cost $6,000 a year more than staff who don”™t. Statewide, health care costs attributable to smoking are $8.1 billion, with $5.4 billion paid by Medicaid. Also substantially avoidable.
If health care costs are a concern, what can you do?
Ӣ Take personal responsibility for the things you control: smoking, obesity, visiting skin cancer stores (a.k.a. tanning salons). Eat less, eat wisely and exercise more. Get an annual physical exam.
Ӣ Sign your health care proxy and share it with your family. Put limits on the treatments you permit. State your desire for an early referral to Hospice when your time comes.
Ӣ Tell your state Assembly member and senator that you support Tort Reform in New York, despite the Assembly leadershipӪs relentless opposition.
If we all act individually, we can improve our own health and the health of our communities. Working together, we can substantially reduce avoidable health care costs and improve the quality of life.
Keith F. Safian has served as president & CEO of Phelps Memorial Hospital Center in Sleepy Hollow for 24 years. He holds an M.B.A. from the Wharton School of the University of Pennsylvania.
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