Reforming Healthcare Part 3: Combating Chronic Disease

The US spent over $4T in 2024 on chronic disease

Introduction

Normally, we talk about healthcare and health insurance in this space and today is no different.  Today we are going to demonstrate a solution to the chronic disease problem.  The format is going to be slightly different with a “Current Situation” section detailing the problem and a “Logical Conclusion" section discussing what will happen if the situation is left unchecked.  Then we will present a short "Solution" section that is separate from the details of the solution itself.  This will give you, dear reader, the opportunity to see the solution quickly and easily without bothering with the messy details, if you like.

The Current Situation

Americans spend 84% of every healthcare dollar on behavior-based, avoidable, chronic disease.  That means over $4T in avoidable expense.

The Logical Conclusion

Left unchecked, the chronic disease plague will bankrupt a healthcare system already teetering on the brink of disaster.

The Short Answer

Educating patients on what to do and when to do it as far as diet and exercise, and giving the patient incentives to follow those instructions in the form of double digit health insurance discounts will at least help and possibly completely avert this crisis.

The Slightly Longer Answer

Let’s look at some numbers and draw some conclusions that support our short answer.

The Problem

Americans don’t take care of themselves. The Commonwealth Fund calculates that there are 336 avoidable deaths per 100,000 lives in the population, versus the OECD average of 225.

We assert that the difference between the average of 225 and the 336 that we see in the US is simply patient education. Doctors aren’t paid to educate; they are paid for procedures. Insurance companies are simply banks that only pay for medical care, and they don’t educate patients, so once again, nobody is minding the store and whatever just happens, just happens. Sure, your doctor can tell you to eat right and exercise more, but what does that really mean?

The Numbers

We looked for and could not find statistics on expenditures on avoidable deaths, but let’s assume that everyone in the OECD receives the same or similar care so we can discount quality of care. Consequently, we can assert that since a third more people die that we spend 1/3 more trying to keep them alive. We as a country spend $5 trillion on healthcare annually and 84% of that is on avoidable chronic disease and mental health. The math tells us that we spend, therefore, $4.2 trillion on avoidable disease. If we then say that 1/3 of that expenditure is avoidable, that means we could save $1.4 trillion, if we were just as good as the average in the OECD. That is a 28% total savings, without changing anything else.

But how are we going to get Ma and Pa Kettle to eat better and exercise more?

The Education

At Sentia, we advocate for solving the health insurance problem by completely automating the health insurance process. We will provide the Electronic Medical Record (EMR) for your doctor and when he documents a procedure, we will pay him for it in real time. That should eliminate about half the cost of health insurance by itself, in lieu of a $10 per month data management fee. Of course the insured still has to pay for the actual incurred risk, but that half number is real and we can save you that. That isn’t really what we are here to talk about today though. Clearly it is possible to live like the average citizen in the 37 OECD countries and have our avoidable death rate equal theirs instead of being 1/3 higher. Here is where the EMR comes in. Since we know everything that your doctor knows, including all your measurements and blood work, we can automatically generate relevant articles for you to follow and be healthy. Since we provide these articles, we can offer a small discount for even reading them. These articles are presented in a problem/solution format with a “temperature gauge” showing how close you personally are to having problems. Then a comprehensive solution, tailored to you individually, is presented. Here is an example:

Since we provide your insurance, we have a vested interest in keeping you healthy and saving everyone money. If we can match the OECD average, then we save that $1.4 trillion annually. The incentive to the individual to make these changes is first, they get to live longer and second that we offer incentives to stay healthy. This puts the teeth into healthy living and we aren’t asking anyone to do more than the OECD average.

The Conclusion

We have shown a way to make patients healthier by educating them on the consequences of their behavior, and a way to capitalize on that to the sum of $1.34 trillion or 27%. If we add that to the process automation savings of our solution, we are in the ballpark of more than 75% savings in total. We already have the best doctors and the best equipment; we just need to implement the above detailed framework to give them all the tools necessary for success.

We have this system in prototype now, fully functioning.

Contact us here or on our site and we will be happy to provide a demonstration of the fully functional prototype.

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We have built a comprehensive health information system to keep the patient healthy and on the right track with the ability to incentivize healthy living. This system includes the automation of the health insurance industry completely.  We have designed and are currently building the ERP style PM system.  Implementing this system should be fairly simple and will completely revolutionize the way healthcare is paid for, saving countless lives. We have shown a way to use this system to make the best healthcare system in the world also the most efficacious and the most affordable.

If you liked what you read contact us here, on our site, SentiaHealth.com, our parent company SentiaSystems.com, or send us an email to info@sentiasystems.com or info@sentiahealth.com