Ten Boring Ways, Ten Creative Ways, to Reduce HC Costs

 A friend asked me what would Chat GPT come up with as ten ways to lower healthcare costs.  It instantly came up with ten - fairly dull, like a Wikipedia article.  I asked for ten out of the box suggestions, and it came up with those too.

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"What are the ten best steps we can take to lower the costs of healthcare in the US?"

ChatGPT

Lowering the costs of healthcare in the US is a complex issue with no single solution. However, the following ten steps represent a broad range of interventions that, collectively, could lead to significant cost reductions while maintaining or improving the quality of care:

1. Preventive Care: Investing in preventive care can reduce the number of patients needing treatment for advanced diseases. This includes vaccinations, regular health screenings, and public health initiatives (like anti-smoking campaigns).
2. Health IT and Electronic Health Records (EHRs): Standardizing and adopting modern Health IT systems can reduce administrative costs, improve care coordination, reduce medical errors, and eliminate duplicate services.
3. Transparent Pricing: Patients often don't know the cost of a procedure or visit until after it has occurred. Making healthcare pricing transparent can allow patients to shop around and make more informed decisions.
4. Limiting Defensive Medicine: Physicians sometimes order tests or procedures not primarily for the patient’s benefit, but to protect themselves from malpractice lawsuits. Tort reform or changes to malpractice laws can reduce the practice of defensive medicine.
5. Drug Pricing Reform: The cost of pharmaceuticals is higher in the US than in many other countries. Policies that negotiate drug prices, allow for the safe importation of drugs, or promote the faster development and approval of generic drugs can help reduce costs.
6. Streamline Administration: A significant portion of healthcare costs arise from administrative tasks. Simplifying insurance-related processes, reducing paperwork, and optimizing administrative tasks can lead to savings.
7. Value-based Care Over Fee-for-service: Transitioning to a system that compensates providers based on patient outcomes rather than the number of procedures performed can incentivize quality over quantity.
8. Chronic Disease Management: With diseases like diabetes, heart disease, and obesity on the rise, implementing more effective chronic disease management programs can result in better health outcomes and lower costs in the long run.
9. Increase Competition: Allowing insurers to sell policies across state lines or creating public options can foster competition and potentially lead to lower prices.
10. Telemedicine: Especially highlighted during the COVID-19 pandemic, telemedicine can be a cost-effective way to provide care for many conditions, reducing the need for physical infrastructure and allowing healthcare professionals to serve more patients in less time.

While these steps can help, the healthcare system's intricacies mean that a holistic approach, considering the interconnected nature of many factors, is necessary for any widespread reform to be effective.

User

Thank you  Those are ten ways to lower costs that would have widespread consensus.   Can you provide ten creative and out of the box ways to lower healthcare costs, do not re-use any of the ten above.

ChatGPT

Certainly! Here are ten creative and "out-of-the-box" ideas to potentially lower healthcare costs:

1. Medical Tourism Facilitation: Encourage patients to travel to countries with high-quality, lower-cost medical services. The U.S. could establish partnerships with such countries to ensure safety and quality of care.
2. Skill Task Shifting: Train and certify mid-level providers like nurse practitioners, physician assistants, and pharmacists to perform tasks traditionally reserved for physicians. This can be particularly effective in primary care settings.
3. Decentralized Home Care with Tech: Leverage wearable and smart home technologies to monitor patients’ health in real-time, reducing the need for in-person visits and enabling earlier interventions.
4. Localized Health Clinics: Establish smaller, specialized clinics for routine treatments and check-ups, leaving hospitals primarily for complex treatments and surgeries.
5. Healthcare Gamification: Introduce apps or platforms that reward patients for healthy behaviors, adherence to medications, or timely check-ups, potentially reducing long-term health issues.
6. Group-based Health Programs: Offer community-driven health classes or group visits where patients with similar conditions learn together, fostering a supportive community and shared learning.
7. Open-source Medical Equipment: Encourage the development of open-source medical devices or tools, reducing the costs associated with proprietary systems.
8. Medical Procedure Auctions: Allow hospitals or physicians to bid for procedures, letting patients choose based on cost and quality. This would introduce a new level of competition among providers.
9. Subscription-Based Medical Services: Instead of paying per visit or procedure, patients could pay a monthly or yearly subscription to a medical practice or group, covering a defined set of services.
10. Public Health Partnerships with Private Sector: Collaborate with private companies to offer public health services, like screenings or immunizations, at popular community locations (e.g., malls, supermarkets, or local events).

These suggestions are indeed creative and would require thorough evaluation, pilot programs, and careful implementation to ensure they lead to both cost savings and the maintenance or improvement of care quality.

BONUS - Ten Worst Causes of Unnecessary Inflation

Thanks!  let's pivot the question.  What are the ten WORST behaviors that contribute to a country's rising healthcare costs?   For example, I might think of (1) monopoly consolidation of hospitals and other venders raises pricing power against purchasers, (2) excessive use of branded products when generic alternativevs are equivalent at a tiny percent of the cost, (3) use of unnecessary tests and services, which might be provider driven or consumer driver.  You can use any of those 3 in your ten if you feel they fit the request.  What are the ten WORST behaviors that contribute to a country's rising healthcare costs? 

ChatGPT

Certainly, understanding behaviors that contribute to rising healthcare costs can help in crafting targeted interventions. Here are ten behaviors or practices that can negatively impact the cost structure of healthcare in a country:

1. Monopoly Consolidation: As you mentioned, when hospitals, pharmaceutical companies, or other healthcare entities consolidate, it reduces competition, often leading to higher prices for services and products.
2. Over-reliance on Brand-name Drugs: Using brand-name drugs when equivalent generics are available at a fraction of the price can significantly inflate costs.
3. Unnecessary Tests and Procedures: Often driven by defensive medicine or misinformed patients, the overuse of medical tests and procedures that aren't clinically indicated can lead to wasteful spending.
4. Fee-for-service Models: In some systems, healthcare providers are paid for the quantity, not the quality, of care they provide, which can incentivize unnecessary services and procedures.
5. Inefficient Administration: High administrative costs due to inefficient bureaucracy, redundant paperwork, or outdated IT systems can inflate the overall cost of healthcare.
6. Lack of Price Transparency: When patients can't compare prices, they can't make informed decisions, which can lead to significant price variations for the same service across providers.
7. Poor Lifestyle Choices: Widespread unhealthy behaviors in a population, such as smoking, excessive alcohol consumption, lack of physical activity, and poor diet, can lead to a higher burden of chronic diseases, driving up healthcare costs.
8. Delayed or Absent Preventative Care: Neglecting preventative measures means more people will develop avoidable health complications, which are often more expensive to treat in advanced stages.
9. Fragmented Care: Lack of coordination among various healthcare providers can lead to repeated tests, missed opportunities for early intervention, and higher chances of medical errors.
10. Ineffective Use of Technology: While technology has the potential to reduce costs, if not implemented effectively, it can lead to inefficiencies, redundancies, and even higher costs, especially with expensive and underutilized medical equipment.

Addressing these behaviors and practices is crucial for any country trying to control its healthcare expenditures while maintaining or improving the quality of care for its citizens.