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Restructure Medicare & Medicaid: In Addition to Life Expectancy, USA Falls Behind OECD Averages in Many Other Health Indicators OECD USA Ranking 2007 Health Indicators USA Median (1 = Best, 30 = Worst) RED = Below Average Obesity (% of total population) 34 15 30 Infant Mortality (per 1,000 live births) 7 4 27 Medical Resources Available (per 1,000 population) Total Hospital Beds 3 6 25 Practicing Physicians 2 3 22 Doctors’ Consultations per Year 4, 6 19 MRI Machines*® (per million population) 26 9 1 Cause of Death (per 100,000 population) Heart Attack 216 178 22 Respiratory Diseases 60 45 21 Diabetes 20 12 20 Cancer 158 159 14 Stroke 33 45 8 KP Note: *MRI is Magnetic Resonance Imaging. Source: OECD. BSF owe poo com USA Inc. | What Might a Turnaround Expert Consider? 317 Restructure Medicare & Medicaid: Effectiveness Research Could Improve Efficiency (i.e., Outputs Track Inputs) e Comparative Effectiveness evaluates different options for treating a condition for a specific set of patients! — Either relative benefits and risks of various treatment options (technology assessment, evidence-based medicine), or — Both clinical effectiveness and relative cost (cost-benefit analysis). e Without rigorous data about comparative effectiveness, according to the CBO: — Treatment decisions often depend on anecdotal evidence, conjecture, and the experience/judgment of involved physicians. — Treatments and types of care vary widely from one area of the country to another. e To affect healthcare spending meaningfully, comparative effectiveness must alter doctor and patient behavior, potentially through reimbursement scheme changes, the CBO notes. e Note that by law, Medicare is effectively precluded from considering costs when making coverage decisions. K P Source: “Research on the Comparative Effectiveness of Medical Treatments”, A CBO Paper, December 2007. (@ EB) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 318 HOUSE_OVERSIGHT_021000