Solving the Problem of Healthcare Economics

CHICAGO–“Healthcare has been on a six-to-seven decade drinking binge that would make even a sailor blush,” said Ron Howrigon, president and CEO of Fulcrum Strategies, a contract negotiation and practice marketing firm based in Raleigh, N.C. “We cannot have half the U.S. economy being spent on healthcare.”

As moderator of a session held during the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, which took place September 9–11 in Chicago, Howrigon used his perspective as an economist to weave together the voices on the panel: two administrative and one medical. The panel shared their experiences with the economics of healthcare from the perspective of a small rural practice, a mid-sized practice intent on growing, and a large hospital practice.

Howrigon opened the session with a description of the current economic landscape of healthcare, noting that the United States currently spends three trillion dollars a year on healthcare. As he explained, “The size is one thing, but it is the trend that is a problem. … All trends like what we’ve seen in healthcare eventually reverse themselves.” While he hopes that the reversal will be gentle, he emphasized that the healthcare industry is three times the size of the entire construction industry, which means that if it crashes, the crash will be spectacular.

While Howrigon painted a grim picture of the future of healthcare, he also noted, “The silver lining is that we are always going to need healthcare,” while adding that it will not be possible to provide everything for everyone. Such an observation led to a brief discussion of the possibility of a single-payer solution to the healthcare problem, but the panel generally agreed that the proposals that have been put forth by the government thus far do not represent good solutions.

The problem of healthcare economics is huge and must be solved, he added. All of the panelists agreed that physicians should play a role in solving it.

Value-Based Care

Kris McGriff serves as an administrator at Oregon Health and Science University (OHSU) in Portland, an academic setting that she describes as full of red tape and hurdles. She explained that her practice’s biggest problem is space constraints, both in the operating room and in terms of hospital beds. McGriff works at OHSU to increase value and quality and decrease cost. She primarily develops patient-focused efforts such as the creation of multidisciplinary clinics that allow patients to receive all of their services on one day. The hospital also works to develop partnerships with community hospitals to improve value for patients.