The Business Case for Ending Homelessness: Having a Home Improves Health, Reduces Healthcare Utilization and Costs
In June 2008, my wife and I moved to downtown Asheville, NC, with our dog, Max. Max and I were out for a walk early every morning and late every evening. When I first started taking Max for walks, I would occasionally notice people who appeared homeless, and I became curious about the causes of homelessness and its solutions.
It is difficult to believe that 5 years have passed since the first issue of American Health & Drug Benefits (AHDB) arrived on my desk in 2008. In February 2008, the United States was on the verge of an economic downturn that had actually begun almost 3 months earlier. The price of oil topped $100 a barrel for the first time, and job losses were just being reported. Although most of us did not know it yet, the United States was entering the worst economic downturn since the Great Depression.
The infuriating reality of healthcare is that it must be run in a systematic way, and that one aspect of that system must be policy (the other 2 are clinical and business). And of course, policy means that politicians ultimately weigh in and “decide” things fundamentally outside their areas of expertise. Not known for consistent fiscal brilliance, their stamp on healthcare often means that much of the downstream effects of legislation consist of crisis management aimed at containing the clinical or economic ruin the legislation overlooked during the planning phase.
New clinical, business, and regulatory healthcare systems are offering unprecedented opportunities for providing quality and value. At the heart of the healthcare debate lay evidence, balance, and competing incentives in search of a point of consensus. Data are poorly understood and do not speak for themselves. Cooperation between stakeholder groups is still elusive, with stakeholder polarization strong, de spite the urge to unite forces. The healthcare system is circling around looking for an organizing principle.
As more and more American families find their budgets pinched by the ever-rising cost of healthcare and a growing volume of scholarly research convinces health policy experts that the quality of American health too often falls short of what it should be—given that Americans spend about twice as much per capita (in purchasing power parity dollars) on healthcare than its neighboring Canada—it is inevitable that the topic of health reform will have a prominent place in the forthcoming presidential elections.
Last month, 2 back-to-back meetings brought out some of the leaders driving the transformation of healthcare into a value-based, patient-centered system. The Academy of Managed Care Pharmacy (AMCP) went first, celebrating its 20th anniversary, followed by the 5th Annual World Health Care Congress (WHCC). Both sessions revealed just how different, and better, healthcare is becoming. Even the warnings about the catastrophic consequences of not improving our healthcare system were accompanied by numerous remedies for it.
Is wellness just a physical matter? Is the burden of disease just a matter of costs? These are obviously rhetorical questions. No one would challenge the notion that health is more than the absence of disease and is at the very least a state of mental and physical well-being. But how often do we try to understand "mental wellness"? How often do we look into screening, diagnosis, intervention, and referral of mental issues in a fragmented mental healthcare system?
Serious and costly performance problems riddle the $2.4-trillion US healthcare system. Because of overuse, underuse, and misuse of healthcare, researchers estimate that roughly 30% of healthcare costs are generated by poor quality.1,2 Therefore, poor-quality medical care will cost about $720 billion in 2008.1,2
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Results 61 - 70 of 81