Wasted Resources and Efforts in Healthcare

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Wasted Resources and Efforts in Healthcare

The cost of healthcare, in most countries globally, is today extremely high due to the wasteful use of resources and efforts. For instance, the United States has among the highest per capita spending on health, yet has worse health outcomes relative to other developed nations. Precisely, more than 30% of medical resources go to waste (Iuga & McGuire, 2014). As such, Americans are among the sickest citizens of the developed world, ranking extremely poorly on infant mortality, obesity, life expectancy, and heart disease prevalence among others. This essay, therefore, discusses the wasted resources and efforts that for a long have made health care exceedingly expensive, yet ineffective.

First, bureaucracy and red tape, especially in the private sector, have led to great losses and wastage of resources in US healthcare. In 2012, for instance, a study revealed that administrative wastage accounted for $190 billion in 2009. Notably, Uwe Reinhardt (a health economist) pointed out more than two decades ago that unnecessary administrative exercise increased the cost of healthcare significantly. The situation has not gotten any better as he revisited the issue again. In 2013, he reinstated his observations backed with the IOM statistics (Evans, 2013).

Second, considerable amounts of healthcare resources are wasted through illicit schemes and illegitimate delivery of healthcare services. Precisely, tens of billions of dollars in the US is wasted on medical-related fraud. In 2014, for instance, the collaboration of the FBI and IOM estimated a wastage exceeding $ 3 trillion from fraud. Further, fraudulent claims constitute more than ten percent of Medicare claims according to the Centre for Medicare and Medicaid Services (CMS) (Wiedemann, 2014).

Some of the ways that the healthcare system is losing hugely include billing for services never rendered, overbilling, performing unnecessary procedures to attract insurance compensation, unbundling, falsifying diagnosis, accepting kickbacks from patients referrals, identity theft, among others. Alarmingly, culprits of these deeds are more than willing to jeopardize patients health to further their illegal and immoral acts (Rudman, Pierce, Eberhardt, & Hart-Hester, 2009).

Third, many resources are wasted by the manner in which insurance is administered. It is estimated that the annual medical wastage related to insurance in the US is $375 billion (Jiwani, Himmelstein, Woolhandler, & Kahn, 2014). Notably, billing and insurance paperwork make the biggest contributions to this wastage. Arguably, these losses can be attributed to the federal governments multi-payer system. Researchers have revealed that the complexity, inefficiency, and the red tape cost related to the multi-payer financing system could be avoided. Conversely, the use of a more simplified single-payer system of financing health care could save the US more than $1 trillion over three years. The single-payer system, used in countries like Canada, proves to be more efficient (Jiwani, Himmelstein, Woolhandler, & Kahn, 2014).

Fourth, patients who do not adhere to medication waste a considerable amount of effort and resources. Although patients are required to adhere to medication for enhanced treatment, a considerable number do not. Consequently, the level of poor outcomes upsurges leading to increased health care services utilization, which translates to extra cost (Iuga & McGuire, 2014). Precisely, nonadherence constitutes an annual wastage of between $100 and $300 billion. Thus, the nonadherence increases the annual health cost by 3% to 10%. Of great concern, only a few high-quality studies on the impact of not taking medication as prescribed are done.

As a result, more emphasis is laid on the negative outcome associated with nonadherence. The impact of adherence has been observed in association with various illnesses such as cardiovascular diseases, pulmonary ailments, psychiatric diseases, metabolic and gastrointestinal ailments among others (Iuga & McGuire, 2014).

Fifth, studies have shown that there is a substantial wastage of resources associated with drug misuse. Commonly misused drugs include antibiotics administered for acute respiratory infections. It is imperative to note that antibiotics on Otitis media, pharyngitis, and other respiratory system infections account for about 75% of ambulatory care prescriptions. However, most of these infections are viral and therefore, not susceptible to antibiotics. It is clear, therefore, that antibiotic treatment is not only ineffective but also unnecessary for these ailments. Notably, there are simple and cheap tools to identify patients who need antibiotics. However, the tests are rarely carried out (Evans, 2013).

Decisively, about 55% of antibiotic prescriptions are unnecessary and constitute of wastage of about $1.1 billion annually. Additionally, overuse of antibiotics results in developing drug-resistant microorganisms. Drug-resistant pathogens render some antibiotics unusable, further increasing the healthcare cost. Although health bodies like the Centre for Disease Control and Prevention (CDC) are attempting to reduce the incidences of unnecessary antibiotic prescriptions, the level of misuse is still high (Evans, 2013).

Sixth, the underuse of appropriate medication leads to not only poor patients outcomes but also huge wastage in healthcare. For instance, ²-blocker therapy following heart attacks has been linked to efficacy but it is not commonly done. If the therapy could have been done well, consequent heart attacks could have been avoided as well as reducing the cost of medication.

Additionally, the number of unnecessary surgical operations is high and is on the rise. As such, there are unexplained variations in the intensity of medical and surgical services. Some of the most common surgeries include overuse of coronary bypass (CABG), overuse of percutaneous coronary procedures (PCI) (Evans, 2013). Further, more often than not, doctors and patients make unnecessary diagnoses. For instance, ailment like back pain, headaches worries patients and therefore, require doctors to do thorough diagnoses. As a result, x-rays, CT scans, pre-operative heart stress testing, repetitive colonoscopies, unnecessary cardiac imaging, are done without proper analysis are done unnecessarily putting patients at higher risks and incurring extra costs.

Lastly, a lot of resources and efforts are wasted treating preventable diseases, especially lifestyle-related illnesses. Annually, $55 billion are wasted managing and treating lifestyle diseases that otherwise could have been prevented (Evans, 2013). It is well known that careful dieting, responsible alcohol intake, avoiding smoking, regular physical exercising among other lifestyle aspects could prevent varied diseases. As a result, some of the patients suffering from lifestyle diseases will not have to seek medical intervention and therefore, cut extra costs.

Conclusively, wastage of resources/efforts in healthcare is apparent. As seen in the discussion, wastage occurs in varied ways including, fraud, unnecessary services, inefficiently delivered care, excess administrative costs, excessively high prices, missed prevention opportunities, among many other unquantified and unreported forms of wastage. Thus, many resources either are allocated unnecessarily or are not utilized optimally. Consequently, the US government is losing billions annually through wastage in healthcare provision, which could be provided in a cheaper and more effective manner (Evans, 2013).

References

Evans, R. G. (2013). Waste, Economists and American Healthcare. Healthcare Policy, 9(2), 12-20. Web.

Iuga, A. O., & McGuire, M. J. (2014). Adherence and Health Care Costs. Risk Management and Healthcare Policy,7, 3544. Web.

Jiwani, A., Himmelstein, D., Woolhandler, S., & Kahn, J. G. (2014). Billing and Insurance-related Administrative Costs in United States Health Care: synthesis of micro-costing evidence. BMC Health Services Research, 14(1), 556. Web.

Rudman, W. J., Pierce, W., Eberhardt, J. S., & Hart-Hester, S. (2009). Healthcare Fraud and Abuse. Perspect Health Information Management, 6, 1g. Web.

Wiedemann, L. A. (2014). Leveraging Data and Analytics to Detect Fraud and Abuse in Healthcare. Journal of Ahima. Web.

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