Editorial: Stop the waste in health care

The ruinously costly U.S. health care system is rife with waste, fraud and inefficiency and is too slow to incorporate better ways of doing things.

As a result, it squanders 30 cents of every dollar spent. That's $750 billion the American public spends every year without getting better health care in return, according to a panel of experts from the Institute of Medicine, an independent adviser to the government.

Thowing that kind of money away is inexcusable -- but it also presents a golden opportunity.

Squeezing some of the fat out of the system would make health care more affordable, trim federal budget deficits and free up billions of dollars for more productive investments that could boost economic growth and improve the nation's global competitiveness. And all of that could be achieved without depriving anyone of the care they need or compromising the quality of the care they receive.

Most of that mountain of money is wasted on unnecessary services ($210 billion), inefficiently delivered services ($130 billion), fraud ($75 billion), paperwork and unnecessary administration ($190 billion), and missed preventive opportunities ($55 billion), according to the institute's analysis of 2009 data.

A second report on the U.S. health care system, published this month in the policy journal Health Affairs, compared the cost and quality of care delivered in various regions of the country. Costs varied widely, for instance from a low of $8,915 to decompress a herniated spinal disc to a high of $14,935. Treating an episode of hypertension varied from $594 to $825. And there is essentially no connection between cost and the quality of care.

The nation would benefit if that list of costly horribles changes the health care debate this election year, moving it beyond the simplistic fight over whether to repeal the Patient Protection and Affordable Care law and the caustic back and forth about whether the $716 billion over a decade that the law trims from Medicare is a raid or a savings.

Call it what you will, there's no question that the rate of increase in Medicare spending, and health care spending generally, must be slowed.

To do that, the institute's panel recommends changing from a system that reimburses providers for procedures and tests to one that rewards high quality care by paying for treatment outcomes. It urges greater use of mobile technology and electronic health records to facilitate information sharing between providers and reduce the need for costly duplication.

And it says doctors and other providers must use data more effectively "to transform the health system into a learning system that continuously improves by systematically capturing and broadly disseminating lessons from every care experience and new research discovery."

The controversial health care law is designed to start the ball rolling on those sorts of changes, but the savings to be realized are uncertain and will likely take years to materialize. If there are better ideas, the nation needs to hear them. How to deliver high quality care for all and control costs in the bargain is the debate we need to have as Election Day approaches.