In perhaps no other country is there a greater abundance of data about health care than there is in the United States. And in perhaps no other country is there more confusion as to what’s really going on.
Take the recent report by powerhouse actuarial firm Milliman (disclosure: Best Doctors uses Milliman for actuarial work). It’s a fascinating report with some of the best information on American health care there is.
The major take-away: U.S. health care costs continue going up.
But when people start interpreting the data, well, that’s where the trouble starts.
For example, NPR reports on why costs are going up:
For three straight years, outpatient care has led all other categories of care in cost increases. Ninety percent of the increase is in more types of care being delivered in outpatient settings.
Factually, of course, this is correct. More and more care is being delivered in outpatient settings.
But it’s not by accident.
In an effort to cut costs, hospitals and doctors, pressed by private and public payers, have been systematically moving what was once in-patient care into outpatient settings. It’s why more and more surgeries are being done on a same-day basis, why diagnostic studies are increasingly done at private centers and not inside of hospitals, it’s why ambulatory care centers are one of the fastest growing segments of the health care economy.
Which raises the broader point.
The American health care economy is so big, complicated and yes, dynamic, that it is difficult to make simple conclusions about it. Causes get lost in their effects, and the success of ideas to reduce health care costs – like doing more outpatient care – end up being called key drivers for rising costs.
Evan Falchuk is President and Chief Strategy Officer of Best Doctors, Inc. Prior to joining Best Doctors, Inc., in 1999, he was an attorney at the Washington, DC, office of Fried, Frank, Harris, Shriver and Jacobson, where he worked on SEC enforcement cases.