5% of Patients, 50% of Cost — where to focus

EmergencySocialThe U.S. spends more than other countries for health care but the outcome is not as good as other countries.  Why?  Many feel it is a failure to respond to the statistic that 5% of patients consume 50% of health care spending.  And, those 5% are often at the bottom of the socioeconomic ladder — either they started at the bottom or drifted to the bottom because of health problems.  See the recent article in Manage Care Magazine.

The health care solutions for the top 95% don’t work for the bottom 5% — because the 5% are not well educated, have unreliable transportation, no phone, smoke cigarettes, and only have part-time jobs.  No matter how much research is done on new drugs and surgical robots if a patient does not have transportation to a health care provider it is money down the drain.

Face the facts:  Sweden spends more money on social services than health care.  The result:  infant mortality rate in Sweden is 1/6 th of the rate in the U.S.   Overall, Sweden spends less on health care and delivers much better results.

Here are the 2009 statistics from the Organization for Economic Cooperation and Development (OECD):



Countries with much higher health care quality (like the UK and France) spend at least twice the amount per person for social service as in the U.S.  The fragmented U.S. healthcare system fails to FOCUS on obvious problems — social service seems to be a lens to sharpen that focus.  It’s easy to see the return on investment for the system when social service provides transportation, navigation through difficult medical situations, health education, home vaccinations, and frequent contacts with pregnant women when needed.  Health care without social service is like building a house without one of the walls — looks great from one side only!

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