Healthcare In 2020 – Best Book I’ve Read In A Long Time

Healthcare in 2020 by Steve Jacob is a great book. Lots of facts. Lots of relevant information. A quick read. Well referenced. If I could, I would send this to every client I’ve ever worked with to help them understand why changing healthcare is so important.

I’m going to share a handful of things from the book here. Even if I could provide you with a detailed summary, I wouldn’t. You need to read this book.

• Estimated MD shortage by 2020 is >90,000 and nurse shortage is 600,000-1M.
• A great quote from two bioethicists (Daniel Callahan and Sherwin Nuland):
  • The medical system’s “main achievements today consist of devising ways to marginally extend the lives of the very sick … for a relatively short period of time – at considerable expense and often causing serious suffering to (the patient)”.
• Of the 30-year increase in US average life expectancy in the last century, only 5 years can be credited to advances in medical care. The rest is from public health measures.
• The number of people 65+ will double to 1.3B globally by 2040 and the elderly will outnumber children <5 for the first time.
• The percentage of people who work out 12 times a month dropped from 53% in 1988 to 43% (in 2009).
• Doctors advise only about 1/3^rd of their obese patients to lose weight.
• The most frequently reported “moderate activities” by US adults are food and drink preparation and lawn and garden care. [Not particularly high on the calorie burning schedule.]
• Nearly 3 out of 4 cancer deaths are attributable to smoking.
• In a 2009 report, about 75% of adults 17-24 were ineligible for the military because they had:
  • Failed to graduate high school
  • Were physically unfit or
  • Had a criminal record
• 1 of 3 homes in US metro areas have at least one problem that can harm health:
  • Water leaks
  • Peeling paint
  • Rodent infestations
• Cancer screenings find lots of pseudo-disease – i.e., abnormalities that meet the criteria of being cancerous but will never grow to become harmful.
• Surveys show a lack of participation in programs:
  • ½ hadn’t been screened for colon cancer.
  • Only 7% used nurse help lines
  • <5% of people eligible used smoking cessation or weight management programs
  • 3 of 4 people didn’t get a flu shot
• Use of decision aids has reduced rates of major elective surgery by ¼ without affecting patient outcomes or satisfaction.
• A physician would need to practice 18 hours a day to provide all the recommended preventative and chronic disease controls to their patients.
• A 2005 study found that nonclinical staff does the most effective job of managing patients with diabetes.
• Per the IOM 2005 report, 30-40% of healthcare spending represented “overuse, underuse, misuse, duplication, system failures, unnecessary repetition, poor communication, and inefficiency.”
• The FBI estimates that 3-10% of healthcare spending is lost to fraud.
• In a research study, parents with sick children saying they had Medicaid or CHIP coverage where turned down 2/3rds of times and had to wait 22 days longer for an appointment than those with private insurance.
• About 40 US surgeries a week are performed on the wrong person or wrong body part.
• 1/3^rd of families lost most or all of their savings because of a terminal illness.

Some scary data points. This book was a great reinforcement of some of the projects I’ve been involved with trying to accomplish the Triple Aim – Quality, Cost, Experience.