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Now, on to Game Changers number two – National Health Plan
While the American population has changed and continues to change rapidly, so too has the health care that it receives. For most of the past four decades, the growth in health care spending has exceeded the nation’s overall economic growth. The result is that the portion of income spent on health care has tripled over that time. And, it continues to grow - rapidly!
Despite being the global leader in health care spending, America ranks 50th in life expectancy, ranks behind most other industrial nations in infant mortality, and ranked last in a 19 nation comparison of health care quality in 2008. The US is the only wealthy industrialized nation that does not ensure that all of its citizens have medical coverage. That lack of coverage translates into an estimated 18,000-45,000 deaths annually. And, medical debt is the primary cause of personal bankruptcy (62%) in the US.
Over the past century the best way to increase health was through public health initiatives – e.g. municipal water and sewage systems. Today the best way is through personal life-style choices involving smoking, alcohol, diet, and exercise. Some 75% of US health care spending goes for the treatment of chronic disorders and about half of all chronic diseases are linked to life-style choices.
Advances in health technology have contributed to growth in spending and will continue to do so. Consider advancements in organ transplants, computerized imaging, stem cells, and pharmaceuticals. Then consider the impact that the mapping of the human genome will have on “individualized health care”. While innovation has been mind bending, experts tell us the rate of innovation in the next 25 years will increase over that of the previous 25 years by a factor of four to seven. Such innovation promises to further fuel health spending in our current delivery system.
When health care spending, technology advancement, exponential growth in senior demographics, and the increased use of health care by seniors are considered together, the issues driving America’s health care reform debate come into focus.
Over the next 8 years (2010-2018) health care spending is expected to increase 75%, from $2.5T to about $4.5T. Stated in a different way, health care spending is predicted to increase 50% faster than gross domestic product.
By 2012 half of all US medical costs will be paid by Medicare and Medicaid programs. By 2017 the Medicare fund will be depleted. There are similar issues with Social Security funding. Then there are the more recent matters related to war funding, recession, bailouts, and unemployment.
While much is said in the national debate about the uninsured (50 million) and under insured (25 million) – about 25% of US population in aggregate, the issue is less about coverage than it is about the economic burden of providing care in the existing heath care delivery system. The cost of putting a healthy blush in the cheeks of all Americans is unsustainable in the existing health system.
Health care is the top social and economic problem in America today! Is change imminent? Bet on it!
So what does all of this mean to professionals involved in the rehabilitation and fitness sectors?
An important question to ask is, “Whose voices will shape emerging federal policy?” One can safely assume that the insurance industry, big Pharma, physicians, and AARP will have influence. One can also safely assume that voices within the rehabilitation and fitness communities are likely to have little influence.
Debate and lobbying continues. It remains uncertain precisely what final outcome will be enacted. However, one thing appears certain in the context of demographics, politics, economic policy – the rehabilitation sector will likely be expected to do more for less. Such a prediction is solidly supported by the reimbursement trends of the last 2 decades.
The game is changing. Practice viability is threatened. The greatest changes are just now taking shape. They will not be implemented overnight but they will be implemented one way or another.
While the American population has changed and continues to change rapidly, so too has the health care that it receives. For most of the past four decades, the growth in health care spending has exceeded the nation’s overall economic growth. The result is that the portion of income spent on health care has tripled over that time. And, it continues to grow - rapidly!
Despite being the global leader in health care spending, America ranks 50th in life expectancy, ranks behind most other industrial nations in infant mortality, and ranked last in a 19 nation comparison of health care quality in 2008. The US is the only wealthy industrialized nation that does not ensure that all of its citizens have medical coverage. That lack of coverage translates into an estimated 18,000-45,000 deaths annually. And, medical debt is the primary cause of personal bankruptcy (62%) in the US.
Over the past century the best way to increase health was through public health initiatives – e.g. municipal water and sewage systems. Today the best way is through personal life-style choices involving smoking, alcohol, diet, and exercise. Some 75% of US health care spending goes for the treatment of chronic disorders and about half of all chronic diseases are linked to life-style choices.
Advances in health technology have contributed to growth in spending and will continue to do so. Consider advancements in organ transplants, computerized imaging, stem cells, and pharmaceuticals. Then consider the impact that the mapping of the human genome will have on “individualized health care”. While innovation has been mind bending, experts tell us the rate of innovation in the next 25 years will increase over that of the previous 25 years by a factor of four to seven. Such innovation promises to further fuel health spending in our current delivery system.
When health care spending, technology advancement, exponential growth in senior demographics, and the increased use of health care by seniors are considered together, the issues driving America’s health care reform debate come into focus.
Over the next 8 years (2010-2018) health care spending is expected to increase 75%, from $2.5T to about $4.5T. Stated in a different way, health care spending is predicted to increase 50% faster than gross domestic product.
By 2012 half of all US medical costs will be paid by Medicare and Medicaid programs. By 2017 the Medicare fund will be depleted. There are similar issues with Social Security funding. Then there are the more recent matters related to war funding, recession, bailouts, and unemployment.
While much is said in the national debate about the uninsured (50 million) and under insured (25 million) – about 25% of US population in aggregate, the issue is less about coverage than it is about the economic burden of providing care in the existing heath care delivery system. The cost of putting a healthy blush in the cheeks of all Americans is unsustainable in the existing health system.
Health care is the top social and economic problem in America today! Is change imminent? Bet on it!
So what does all of this mean to professionals involved in the rehabilitation and fitness sectors?
An important question to ask is, “Whose voices will shape emerging federal policy?” One can safely assume that the insurance industry, big Pharma, physicians, and AARP will have influence. One can also safely assume that voices within the rehabilitation and fitness communities are likely to have little influence.
Debate and lobbying continues. It remains uncertain precisely what final outcome will be enacted. However, one thing appears certain in the context of demographics, politics, economic policy – the rehabilitation sector will likely be expected to do more for less. Such a prediction is solidly supported by the reimbursement trends of the last 2 decades.
The game is changing. Practice viability is threatened. The greatest changes are just now taking shape. They will not be implemented overnight but they will be implemented one way or another.
When games change there are a number of predictable responses by those who will be impacted by the change – surprise, denial, rationalization, depression, and giving-up are common.
But there are also the few who look change in the eye and soberly and systematically set about preparing for it with the knowledge that in doing so they will achieve competitive advantage and opportunity. In taking action sooner rather than later, they also realize that there are short term and midterm benefits that will further enhance their financial and competitive future. Some practices will not survive.
Will current services, practice patterns, treatment philosophies, utilization, professional development, productivity, profitability, and business models carry forward into the new game that others are creating, but in which you will be expected to practice? Is your practice stable today? Is it sustainable through the changes that are on the horizon? Are you prepared to practice differently? Are you prepared to do more for less? Is your practice evolving at a pace that will ensure a benficial future for yourself and those you serve?
The Blushing of America is truly a game changer that demands your awareness and action. It will impact your profession, your career, your compensation, your job security, and your family’s prosperity.
The paradox is that there is an exploding population that needs rehabilitation and fitness services to remain healthy, productive, and independant, while at the same time the finanical resouces for providing such services are rapidly being eroded by other interests.
More next post - Obesity!
All The Best!
Bob
(c) Copyright 2009
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