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Framing Health Care Systems Challenges


Joel Moses, Institute Professor; Professor of Computer Science and Engineering and Engineering Systems; Acting Director, Center for Technology, Policy and Industrial Development

Three key issues in transforming U.S. health care are access, quality, and cost. The political system is trying to provide access to health care insurance to the 45 million Americans who currently do not have it. Improving the quality and safety of outcomes in health care is a goal in every society.

Arguably cost is the key issue in the U.S. health care system today. In 2007 the U.S. spent 16% of its GDP (about $2.4 trillion) on health care. Most European countries spent 11% or less, a difference of $700 billion per year. Moreover, the growth in the overall cost of U.S. health care is approximately double the inflation rate. This situation is simply unsustainable.

Improving the quality of health care outcomes can reduce cost by, for example, reducing the need to redo procedures. Increased use of IT in electronic health records (EHR) can improve quality by, for example, avoiding errors in medications. The information in EHR databases can be used to determine evidence for the effectiveness of procedures and thereby lead to reducing waste in the system. Some restructuring of the health care system can also greatly decrease cost. While greatly reducing cost we want to maintain our systemís innovation in new medical procedures, new drugs, and new devices. Finally, we must recognize that one of our societyís real goals is to increase wellness for its population, thus avoiding many interactions with health care system altogether.

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