As I said recently, I’ve been writing less here for a number of reasons. One is that I’ve been asked to write on other sites. Another, a sobering factor, as that after years of study, I’ve concluded that the American healthcare system has tied itself in a fatal knot. The post shown here, on the Patient Power blog, is an example of both.
You can use this to understand enormous sums of money, too:
$1 = one grain of rice
$1000 = cup of rice
$1 million = 8 bags of rice
$1 billion = 3 trailer trucks of rice
$1 trillion = 2 ocean freighters (3,000 truckloads)
$3 trillion (the US healthcare budget) = 6 ships (9,000 truckloads)
When someone says a health improvement project will save (or cost us) $100 million a year, it’s a lot, but think:
- The proposed amount is like 800 bags of rice.
- The US health budget is 9,000 truckloads of rice
Puts it in perspective.
Thanks to @Green_Goddess, Caroline Taylor, CMO of IBM Global Markets, for the visualization, and to @Sasanof for tweeting it. Don’t I love how social media helps ideas spread??
Update next day:
One of my very early blog posts, on my old blog, was on this same subject. March 9, 2009: Comprehending the US healthcare budget. Here are the graphics from that one:
Here’s 100 times as much – a million hundred-dollar bills, $100 million:
Ten of those – a billion:
And a thousand of those – a trillion. Check out the little dude, who’s now in the bottom left corner:
And US healthcare is three times that size.
This helps me, for one, start to comprehend the magnitude of the problem. Something like that does not shrink willingly: lots of people would lose their jobs, including CEOs etc. That’s why I liken US healthcare to “a tumor that doesn’t know how to stop growing and killing its host.”
Go back up and take a look at the size of one million in this picture. Urk.
After years of study of healthcare around the world, listening to an immense number of arguments about what’s important and what works and doesn’t, it’s all summed up in this one picture. The Y axis is life expectancy; the X axis is cost. This graph has been tweeted furiously and often lately by health journalist @DanMunro. (More on him below.)
You can easily see that US health costs per capita are way, way, way out of whack with the rest of the world. And, the life expectancy we get for it is years worse than the countries that cost 2-3x less.
Some will argue bitterly that the facts aren’t relevant, or a hundred other arguments. I’ve lost interest in those arguments, because they’re all about rationale, and no rationale is worth a damn if the outcomes they’re trying to explain don’t match the rationale.
For years I’ve blogged about the difficulty of shopping responsibly for healthcare. Well, late last week some big news broke – big enough that I did an overnight makeover of my home page and added a new page to my site. This is the first chance I’ve had to blog about it.
The news is that the work of my longtime friend Jeanne Pinder at ClearHealthCosts is finally getting the widespread attention it deserves: in New Orleans, award-winning investigative reporters at both Fox 8 TV and the Times-Picayune newspaper have dug right in and started using the ClearHealthCosts software system both to report the insane price variations and, importantly, let the public submit more to flesh out how much is known.
Fox 8 reporter Lee Zurik fired the first salvo, a 7-1/2 minute long segment – which, as you know, is a huge length of time for an evening news piece. Then Times-Picayune investigative reporter Jed Lipinski posted his separate piece – see screen capture above.
Here’s my page on the series with links to both pieces and all my past posts: Cracking the Code.
More to come, and here’s hoping many cities follow. We, the suffering consumers, danged well deserved to know where our money is going, and we deserve to know what our options are, before the bill arises.
Long-time readers know that in 2012 I was on high deductible insurance – and I don’t mean Obamacare-style $3,000 deductible, I mean $10,000 deductible. I chose that gladly, because I had laboriously analyzed the five plans available to me. I know insurance is a game of sharing risks, so I analyzed (it took all my Excel skills) and chose.
What happened next is described in a column in today’s NY Times by Tina Rosenberg, Shopping for Health Care: A Fledgling Craft: within months I discovered I had a skin cancer on my face. I became a highly motivated shopper, and quickly discovered nobody could tell me what would be on my bill.
The details are in several skin cancer posts here. But Tina Rosenberg writes about social problems, and I want to draw attention to the nature of this social problem: it withholds power from the person whose health is at stake, and that’s just plain wrong.
I was interviewed recently by USA Today reporter Laura Ungar of the Louisville Courier-Journal. The story ran Monday 9/14 in that paper and will be in the national USA Today soon. (I expected it on Tuesday 9/15 but it’s not there.)
The subject is summed up perfectly by the headline: Wildly varied health costs a national mystery.
Regular readers of this blog are familiar with my years-long series of posts Let Patients Help: Cost-Cutting Edition, especially my efforts to shop responsibly to get a skin cancer treated. If you’re not familiar with it, and you have the stomach for it, sit back with a cup of your favorite beverage and start digging. (For a shorter version, read the final post, which is pretty unsettling.)
Why do I ask you to read it? Because I believe this is important to the future of health(care) in America. We must put an end to this crap. Providers, give us the facts! Tell us what things will cost, so we can decide what’s important to us!
Good providers who are trying to do a good job at a good price simply cannot win our business in an environment that, 9 years after the original article in Health Affairs, is still best described as that article’s title did: “Chaos behind a veil of secrecy.”
Can you believe that this situation is tolerated and nobody is getting busted? As I told Laura in the interview:
There can be no explanation other than some secret malarkey going on. …
I feel disempowered and disrespected, because aside from the incredible cost crunch we’re all experiencing, it’s a downright sin that my family can’t readily find out what the options are and what the costs are.