July 21, 2009 / 12:15 AM / 10 years ago

Healthcare reform needs better choices: report

WASHINGTON (Reuters) - Telemedicine, workplace clinics and finding ways to help people stay healthier may be more important for reforming the U.S. healthcare system than insuring everyone, according to a report to be released on Tuesday.

A doctor checks the blood pressure of a patient in Los Angeles July 30, 2007. REUTERS/Lucy Nicholson

Incentives will be needed to encourage people to change their ways before they develop heart disease, diabetes and other so-called lifestyle diseases that now eat up so many medical resources, consultant Pricewaterhouse Coopers said in the report.

“Cranking up supply to increase access is likely not the answer. The United States now spends more than any nation on healthcare and has a record number of clinicians in the workforce,” the company said in a statement.

“Instead, solutions will lie in new models of care and in using technology, incentives and behavior change to unclog the jammed access points.”

Congress is working on legislation that would set up a government-run health insurance plan to compete with private insurers, provide coverage to many of the 46 million uninsured and try to stem runaway medical costs.

President Barack Obama, trying to rally support for reform efforts, said on Monday lawmakers must overcome their differences and enact reform now because spiraling healthcare costs were weighing on American families.

The PricewaterhouseCoopers’ Health Research Institute team conducted 37 in-depth interviews with officials at healthcare providers, the Veterans’ Administration, community health centers and other groups, read other studies and commissioned an online survey in April of 1,000 consumers.

They found half of those surveyed would be likely to seek healthcare online. “In Hawaii, more than 1,000 health plan members have engaged in an online consultation with physicians since the service was launched in 2009,” the report reads.

The Veterans Health Administration has said it has reduced use of its system by 30 percent over six years using telemedicine — remote consultation, diagnosis and sometimes even treatment using video or online links.


“Ten percent of employers surveyed by PwC in 2009 said that they’re providing worksite clinics, up from 1 percent in 2008,” the report adds. “Of consumers surveyed by PwC, 37 percent said they’d be likely to use a worksite clinic, and 36 percent said they’d be likely to use a retail clinic.”

One frequently cited problem is the overuse of expensive emergency departments. Half of those surveyed said they had visited an emergency room for a need other than an emergency during the last 12 months. “Medicaid patients use hospital emergency departments twice as much as the uninsured,” the report reads.

The use of emergency departments rises with the ratio of people with insurance. States with the most people lacking health insurance had lower rates of emergency department use — a finding that challenges the common wisdom that uninsured people and illegal immigrants are clogging hospital emergency rooms.

Hospitals often encourage this behavior, the report found. “Many hospitals are marketing and expanding their EDs as a way to increase admissions,” the report reads. “About one-third of patients who go to EDs were admitted for an inpatient stay.”

“It’s clear that access to insurance coverage does not translate into access to care,” Dr. David Chin, leader of the PricewaterhouseCoopers Health Research Institute said in a statement.

The study also said people will have to be encouraged to lose weight, eat healthier foods and exercise more — behaviors linked to diabetes, heart disease and fully one-third of all cancers.

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