QUESTIONS AND ANSWERS ABOUT HEALTH CARE COSTS AND VALUE

1. How have health outcomes improved in the last 20 years?  What are some specific measures of quality?

In the past 20 years, each additional dollar spent on health care services produced health gains valued at $2.40 to $3.00.  Though annual age-adjusted per person health care costs between 1980-2000 increased by $2,254 (102 percent), this was accompanied by significant health gains such as the fact that annual death and disability rates declined, and a key measure of population health, the number of days in the hospital, declined from 129.7 to 56.6 per 100 persons.

Simply put, without the investment in health care that brought about these health care improvements, the U.S. would have experienced 470,000 more deaths, 2.3 million more people with disabilities and 206 million more days spent in the hospital.

Leading diseases have also seen improvements in health outcomes. Today’s patients who suffer a heart attack are far less likely to die as a result; death rates have declined from 345 to 186 deaths per 100,000 persons. Stroke and breast cancer outcomes have seen similar declines.

Major financial investments have been made in these common diseases – effective health care management practices and technological and drug innovations have significantly improved outcomes.  These advances are composed of many innovations including pharmaceuticals, medical devices, surgical techniques, and diagnostic technologies.

2. But was the major financial investment in health care really necessary?  Wouldn't we have seen these improvements without so many resources directed towards health care?

Americans direct substantial resources toward health care research and the development of new medical technologies and treatments, and American patients reap the benefits of this investment.  Their European counterparts have reduced their health care investment to their detriment. The result of the American investment in health care: new pharmaceuticals, medical devices, and treatments are first unveiled in the U.S., not in Europe. This means that American patients are assured more timely access to health care on the cutting edge. For this very reason, researchers are beginning to observe a widening disparity in health outcomes between the U.S. and Europe.

3. How can Congress help ensure that legislative proposals consider the value of new health care technology and treatments as well as their costs? 

Congress must remember the physician's edict, "First do no harm."  When considering legislative proposals, it must first reject any that would result in increasing the health care cost burden. Mandates on employers and health plans must be rejected. In addition, Congress must do what it can to decrease costs.  Reforms to address the crisis in medical liability costs must be a priority.  Legislation to establish chronic disease management was a good beginning, but Congress must continue to support these efforts.
In addition, Congress must carefully evaluate proposals such as pharmaceutical importation and price controls, as well as potential budget cuts for providers, according to their impact on valuable health care investment. Measures like these would have a dramatic impact on treatments and services available to American patients and should be rejected.