Health care costs have the capacity to render persons bankrupt and is an expense that Government and all of us will have an interest in keeping as low as possible.
The United States (US) is a great example of how high health care costs can have a negative effect on individuals and health seeking behaviour.
Medical debt is the leading cause of bankruptcy in America. An individual's deductible from health insurance provided by their job in the US can be more than US$1,000 per month (equivalent to more than J$128,000) compared to Jamaica's, which is usually around J$1,500, depending on the plan (equivalent to about US$12).
Jamaica now enjoys relatively affordable private health care when compared to some developed countries. Additionally, we have a no-user-fees policy at public facilities for most services, and this ensures that every Jamaican has access to health care. Despite this, not all illnesses can be addressed in the public sector and resources are not there to cover all needs, so private health care will always be a necessary option.
If we want to ensure that we keep down health care costs so that we retain the kind of access that we now have, we must take the steps necessary to slow the increase of these costs in Jamaica.
DIGITISE HOSPITAL
Health technology can play an important role in this process. What the technology can do is streamline and bring efficiency to various processes. For example, a digitised hospital would be able to better manage its inventory reducing waste from expiration, theft and overuse.
This has the potential to save millions of dollars that can be focused in other important areas. Hospitals can also benefit from linkages and have shared resources which would also reduce costs. These same benefits can be applied to private medical offices, labs and pharmacies. With lower operational costs, there will be lower charges.
Another area where technology can assist in reducing cost is in the management and monitoring of people's health. It may seem like higher health-seeking behaviour would mean more visits to medical facilities and, therefore, higher health costs. The opposite is true.
Higher health-seeking behaviour means that the population, being more conscious of their health, could be aware of illnesses before they get to a stage where treatment becomes very costly. It also means that risks can be detected and interventions put in place, saving significant sums that would otherwise be used in treatment. It is well known that prevention is better, and cheaper, than cure.
FRAUD DETECTION
Digitisation can also save millions of dollars by keeping fraud out of health systems or by facilitating quicker and easier detection of any potential fraudulent activity, much like the National Health Fund (NHF) has done with its individual benefits programme.
Using technology, the NHF can monitor and track prescriptions filled under its benefits programme down to the formula of the drugs to avoid duplication - using the copyrighted Caribbean Drug Codes. This has helped the NHF to keep the cost of administering its benefits programme significantly lower than other similar programmes in the Caribbean. In this way, beneficiaries can continue to access drugs without there being significant increases in cost for their portion of the payment. It also helps to keep the NHF sustainable.
Savings can also be realised through digitised linkages in health care for the purpose of adjudicating insurance benefits, which means that insurance companies do not have to significantly raise their rates. This is because they are able to detect fraud, wastage, or anything that could affect benefits, collections and profits in a negative way. They are also better able to plan and forecast client needs.
There are many risks associated with high health costs, including low productivity. Keeping health costs affordable will enable persons to access care, especially for high prevalent non-communicable diseases such as cancer, diabetes and renal failure.
- Doug Halsall is the chairman and CEO of Advanced Integrated Systems. Doug.halsall@gmail.com
Published:Sunday | October 29, 2017 | 12:00 AM Doug Halsall
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