New Health Dialogue - logo

COST: Small Successes in a "Mega-Mess"

The Washington Post reviews the growing consensus and awareness about the amount of waste in our health spending. The piece includes "one small vignette" of success in what one health executive called a "mega-mess," and one note of hope that people will soon be in the right places to start fixing it.

"We're not getting what we pay for," says Denis Cortese, president and chief executive of the Mayo Clinic. "It's just that simple."

The "vignette" involves Starbucks, Aetna, and Seattle's Virginia Mason Medical Center, which as we've noted in the past has a reputation as a health-care efficiency innovator. Apparently all that coffee-pouring is hard on one's back, so Starbucks was spending big bucks on MRIs. Even though there is little scientific data that MRIs help in such cases. Ceci Connolly writes:

So they flipped the process, trying physical therapy first. To make up for some of Virginia Mason's lost revenue, Aetna increased its payment for the therapy. Today, the majority of Starbucks employees with back trouble return to work within 48 hours without an MRI or a prescription.





Lower costs. Better outcomes.

Getting there is hard, though, requiring changes in the culture of medicine, in the expectations of patients, in the way we pay doctors, even the congressional politics of health care decision-making. But former Senate Majority Leader Tom Daschle, poised to be the next Health and Human Services Secretary, has spoken and written widely on the need to make health spending more evidence-based, apolitical, and rational. And Peter Orszag, outgoing head of the Congressional Budget Office and incoming director of the Office of Management and Budget, says we'd save bundles even if we capture only a third of the waste. "Given the scale of it," Orszag told the Post, "I am puzzled as to why we are not doing more to improve the efficiency of the health system."