Saving Healthcare in America: Patient Education Will Reduce Costs by $1.25 Trillion

Introduction

Spending is out of control here in the United States. We usually blame insurance companies, and we should, but there is a huge elephant in the room: chronic disease. Today, we will show how to save over 25% on the total health expenditure in the US.

The Problem

Americans don’t take care of themselves. The Commonwealth Fund calculates that there are 336 avoidable deaths per 100,000 lives in the population, versus the OECD average of 225.

Figure 1 - Avoidable deaths per 100,000

We assert that the difference between the average of 225 and the 336 that we see in the US is simply patient education. Doctors aren’t paid to educate; they are paid for procedures. Insurance companies are simply banks that only pay for medical care, and they don’t educate patients, so once again, nobody is minding the store and whatever just happens, just happens. Sure, your doctor can tell you to eat right and exercise more, but what does that really mean?

The Numbers

We looked for and could not find statistics on expenditures on avoidable deaths, but let’s assume that everyone in the OECD receives the same or similar care and we can discount quality of care. Consequently, we can assert that since a third more people die that we spend 1/3 more trying to keep them alive. Yes, that is a big reach, but bear with me for a moment. We as a country spend 4.7 trillion on healthcare annually and 84% of that is on avoidable chronic disease and mental health. The math tells us that we spend, therefore, $3.95 trillion on avoidable disease. If we then say that 1/3 of that expenditure is avoidable, that means we could save $1.27 trillion, if we were just as good as the average in the OECD. That is a 26.9% total savings, without changing anything else.

But how are we going to get Ma and Pa Kettle to eat better and exercise more?

The Solution

At Sentia, we advocate for solving the health insurance problem by completely automating the health insurance process. WE will provide the Electronic Medical Record (EMR) for your doctor and when he documents a procedure, we will pay him for it in real time. That should eliminate about 47% of the cost of health insurance by itself, in lieu of a $10 per month data management fee. Of course the insured still has to pay for the actual incurred risk, but that 47% number is real and we can save you that. That isn’t really what we are here to talk about to day though. Clearly it is possible to live like the average citizen in the 37 OECD countries and have our avoidable death rate equal theirs instead of being 1/3 higher. Here is where the EMR comes in. Since we know everything that your doctor knows, including all your measurements and blood work, we can automatically generate relevant articles for you to follow and be healthy. Since we provide these articles, we can offer a small discount for even reading them. These articles are presented in a problem/solution format with a “temperature gauge” showing how close you personally are to having problems. Then a comprehensive solution, tailored to you individually, is presented. Here is an example:

Figure 2 - Patient Education

Since we provide your insurance, we have a vested interest in keep you healthy and saving everyone money. If we can match the OECD average, then we save $1.267 trillion annually. The incentive to the individual to make these changes is first, they get to live longer and second that we offer incentives to stay healthy. This puts the teeth into healthy living and we aren’t asking anyone to do more than the OECD average.

Since we also have control of the education, we can update it with the latest science as new facts are discovered. We absolutely do not have a credibility issue (like the CDC and the COVID vaccines) because we are not going to advocate for anything that makes a patient sick and therefore costs us all money.

Conclusion

We have shown a way to make patients more healthy by educating them on the consequences of their behavior, and a way to capitalize on that to the sum of $1.27 trillion or 27%. If we add that to the process automation savings of our solution, we are in the ballpark of more than 60% savings in total. We already have the best doctors and the best equipment; we just need to implement the above detailed framework to give them all the tools necessary for success.

We have this system in prototype now, fully functioning.

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