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Opinion

Bessent: Health care waste, fraud and abuse -- all true

"The socialization of health care in the United States didn't start with Obamacare, or even with the introduction of Medicare and Medicaid in 1965. It got rolling in 1945," writes Lane Filler. Credit: Getty Images, 2012

The ruinously costly U.S. health care system is rife with waste 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 care in return, according to a panel of experts from the Institute of Medicine, an independent adviser to the government.

That’s inexcusable -- but it also presents a golden opportunity.

Squeezing some of that 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 last week in the policy  journal Health Affairs, compared costs and quality from one region of the country to another. It found that the highest costs are more than 10 times the lowest when treating the same chronic medical condition. And there is essentially no connection between cost and the quality of care delivered.

The nation would benefit if that list of costly horribles changes the political debate over health care this election year, moving it beyond the simplistic fight over whether to repeal Obamacare 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 it 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.”

How to do those things and more to deliver quality care for all and control costs in the bargain is the debate we need to have as election day approaches.

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