December 14, 2020 Post & Courier
(Charleston, SC)
A new report on health
care costs in the United States is making waves for a reason never seen before
- health care spending appears to be about 2 percent lower this year than last.
For context, this slight
decrease is the first one ever observed since data on health care spending
first became available in the 1960s, according to the Kaiser Family Foundation
report .
That sounds like a good
thing, right? After all, health care costs in the United States are
exorbitantly high compared to other countries. The Centers for Medicare &
Medicaid Services report that total health care spending here reached $3.6
trillion in 2018, accounting for nearly 18 percent of the United States' Gross
Domestic Product. No other global power comes even close.
But public health experts
and economists agree that the reasons behind this drop in health care spending
aren't completely encouraging. That's because the decrease is directly tied to
the pandemic and it proves that many Americans are forgoing care that they
need, such as cancer screenings and immunizations.
In a state like South
Carolina, where cancer rates are already considerably higher than the rest of
the country, missed appointments and delayed care will likely spell much bigger
problems - and higher costs - down the road.
"You're probably
going to see exponential increases in health care spending," said Melanie
Cozad, an assistant professor at the University of South Carolina's Arnold
School of Public Health.
She noted that the bulk
of health care spending in the U.S. is observed at end-of-life. Catching cancer
earlier, for example, saves lives and saves the system money. But that happened
less frequently in 2020 when most hospitals and health care providers across
the state suspended the bulk of elective procedures this past spring.
"To me, as a
economist, it's a short-term versus long-term trade off," Cozad said.
Kelli Kennison, a
clinical assistant professor at the Arnold School of Public Health, agreed with
Cozad that the decrease in spending this year signals future problems.
"Mammographies are
down. Colonoscopies are down," Kennison said. "The immunizations are
really concerning, as well. Catching all of those children up on immunizations
... is going to be a challenge for the health care system."
For what it's worth, the
2 percent drop in health care spending is only a momentary blip in time, said
Robert Hartwig, an economist and the co-director of the Risk and Uncertainty
Management Center at the Darla Moore School of Business.
There is every reason to
believe that the system will make up most of its losses in 2021, he said.
Hospitals in South Carolina and across the country lost billions of dollars
when they suspended elective procedures this past spring. And while the
COVID-19 pandemic continues to surge across the country, hospitals and other
health care providers, such as dentists and optometrists, are keeping their
doors open.
"They're being much
more judicious in terms of making decisions," Hartwig said. "It'll be
far less painful (in terms of financial losses) to health care providers than
it was earlier in the year."
Stock prices for health
insurance and life insurance companies have similarly rebounded, Hartwig said,
offering another indication that the health care economy is well on its way to
recovering any losses incurred earlier this year.
While the 2 percent slip
in spending won't likely usher in any long-term trends in terms of health care
spending, experts agree there is a silver lining. The pandemic has forced
providers, patients and health insurers to embrace the use of telemedicine - a
platform that could help reduce health care spending in the long run by saving
time and reducing the amount of physical space doctors and their staff need to
deliver care.
Historically, health
insurance companies have paid doctors and hospitals more money to treat
patients in person. This still remains the case, but reimbursements for telemedicine
visits are increasing, said Dr. Edward O'Bryan, the executive director of MUSC
Health Solutions.
And higher reimbursements
offer an incentive for providers to promote digital appointments.
Before the pandemic,
there was less than a one percent adoption rate of "true telemedicine
services" among patients in the U.S., he said. "It was very slow
going."
According to the Centers
for Disease Control and Prevention, the use of telemedicine during the last
week in March this year was up 154 percent compared to the same week in 2019.
Providing health care
this way just makes sense, O'Bryan said.
"It's always
fascinated me when you're sick with something - you don't know what it is - you
go sit in a waiting room with other sick people. It's a ... strange concept,"
he said. "That's exactly how pandemics start - crowding sick people
together."
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