Today's Advisory Board reported on a
JP Morgan Chase's CEO letter to stockholders in which Jamie Dimon highlighted six critical problems and issues contributing to healthcare costs (and our national deficit) that the venture will address in its effort to recast the American healthcare system:
- Aligning incentives system-wide - our healthcare system has the highest costs associated with the worst outcome because we're getting what we incentivize.
- Studying the extraordinary amount of money spent on waste, administration and fraud costs.
- Empowering employees to make better choices... by owning their own healthcare data... with more consumer-driven health intitiatives
- Developing better wellness programs around obesity and smoking which account for approximately 25% of chronic diseases
- Determining why costly and specialized medicine and pharmaceuticals are frequently over- and under-utilized.
- Examining the extraordinary amount of money spent on end-of-life care; often unwanted.
I was struck by a couple of things:
The first point has always seemed obvious, but this is the first time I have seen so public a figure address it. It makes me wonder how our healthcare system got to this point, and whether there are aligned incentives on which we can all agree.
Other points seemed to me to be straight out of our playbook:
- We constantly work to minimize waste, combat fraud and abuse, and to streamline our operations. The April 1, 2018 edition was entirely devoted to leveraging the multi-hospital pharmacy enterprise for that purpose.
- As both acute and ambulatory providers, we are often at the forefront of combating obesity and smoking.
- The proper use of pharmaceuticals has been our mantra for the last 40 years (or longer)
- As we reach out to our broader care venues, we find ourselves at the forefront of telepharmacy and other technological needs for bringing healthcare to patients and investing them in their own care
End-of-life care is an area where we might also find ourselves as significant advocates, especially around continued use of pharmaceuticals. We may well disagree among ourselves regarding what is, and is not necessary to treat at the end of life. I can share a deep sense of gratitude to a hospice organization and a compassionate set of caregivers who cared for my recently departed mother, whose most effective therapy was presence, a kind word, a warm touch, and resolutely protecting her from calls for therapy that could only have the effect of reducing the quality of her remaining days. It's a hard place to be when you are taught to bring the full force of medical science to bear on a patient's maladies, but death is a malady none of us escapes. Perhaps there is more work we can do there.
In any event, as you can tell, reading through this list stirred a bunch of thoughts for me; hopefully they did for you was well.
What do you think of these six points?
Dennis A. Tribble, Pharm.D., FASHP
Ormond Beach, FL
DATdoc@aol.com
The opinions expressed herein are my own, and not necessarily those of my employer or of ASHP