Surgery the biggest cost, say Gawande

According to Reuters, Dr. Atul Gawande, a surgeon who was named this week to head the company being formed by Amazon, Berkshire Hathaway and JPMorgan Chase to trim employee healthcare costs,  cited surgery as the single biggest U.S. healthcare cost and said there are ways to both cut costs and improve patient care. 

Gawande, 52, is a surgeon, writer and public health thought leader and practices general and endocrine surgery at Brigham and Women’s Hospital in Boston.  He is also a professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School and founding executive director of the health systems innovation center, Ariadne Labs. Gawande also is a staff writer for The New Yorker magazine and author of four books on health care.

End-of-life care needs to take into account the wishes of patients, something which he said is now sorely lacking. 

“...pharmaceutical costs ...  is just 10 percent” of total U.S. healthcare spending, Gawande said, noting how patients faced with a $200 drug co-pay see that as standing between them and their health. But surgery is the single biggest healthcare cost, and Gawande outlined ways he has worked with hospitals to standardize procedures, resulting in lower costs and better results for patients. 

“We need to act through data tracking ... to see when treatments are benefiting and when they are not,” Gawande said.

At his speech Thursday at the America’s Health Insurance Plans conference in San Diego, Gawande said “It’s a long road, but it clearly is possible.”  In his speech Thursday, Gawande also said:

  • It took five years to substantially reduce mortality among previously uninsured people who received coverage, led by reductions in death caused by chronic conditions, such as heart disease, cancer and HIV.
  • Insurance must cover pre-existing conditions, because “life is a series of chronic conditions.”
  • Catastrophic health-care coverage is ineffective because many people don’t have enough money in the bank to cover their deductibles.
  • “The goal of a health-care system is not survival at all costs. The goal of a health-care system is not a good death. The goal is a good life.”