Half Nots

You’ve certainly heard the old business saw, “Only half of my advertising works – now if I only knew which half.”

Now consider something of infinitely greater importance – government spending on healthcare.

Next year government programs will account for more than half of all dollars spent on U.S. healthcare spending. By 2020 about one in five dollars spent in the U.S. will go to health care.

Public funds accounted for 47% of the $2.34 trillion of national health spending in 2008, the last year for which figures are available. CMS estimates, in a paper to be published Thursday in the journal Health Affairs, that the proportion will rise to 50.4% by 2011.

Are we spending too much – or are we not spending it in the right way?

Much debate over what “too much” is – but very little argument that we need to spend more smartly.  What does “smartly” mean? There’s the rub.  Well, for starters, it must mean getting patients (aka “people”) on the best, most effective therapies as quickly as possible.  It doesn’t mean forcing physicians to “fail first” on less expensive options.  That’s not only contrary to the public health, it’s pernicious to the public purse. Skimping on a more expensive medicine today but paying for an avoidable hospital stay later is a fool’s errand.

When it comes to healthcare spending and healthcare reform, we’d do well to remember the words of Winston Churchill:

“There are a terrible lot of lies going around the world, and the worst of it is half of them are true.”

Which “half” indeed?