Spokane Journal of Business

Guest Commentary: Health care costs, quality should top Congress’ slate


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When Congress convenes next year, lawmakers must focus on the cost and quality of health care.

In November, voters made it clear that health care was on top of their minds. According to the Kaiser Family Foundation, a third of voters said it was the “most important” issue. It ranked higher than the economy and jobs.

What’s driving Americans is their fear of losing health insurance, their home, and savings if they have to battle cancer or other life-threatening conditions.

According to the Washington Post, our country spent $3.4 trillion on health care in 2016, and that number is projected to jump to $5.5 trillion by 2025.

A study by the Centers for Medicare and Medicaid Services projects that the average growth in health spending will be even faster between 2016 and 2025, at 5.6 percent per year. The costs are driven by an aging population and an inflation in the cost of medical services and products.

Those costs are hitting our budgets hard. According to the annual Milliman Medical Index, a typical family of four insured by the most common health plan offered by employers will average $28,166 this year. 

That’s up from 2010, when the costs crossed $20,000. Just two years ago, it topped $25,000, the Post added.

In an effort to bend the costs downward and improve health care, Amazon’s Jeff Bezos, Omaha billionaire investor Warren Buffet, and JPMorgan Chase CEO Jamie Dimon pooled their resources and hired Dr. Atul Gwande, a prominent surgeon and author, to lead the endeavor.

Gwande is a critic of America’s health care system and is viewed by some as a disrupter who is highly qualified. 

Dr. Robert Pearl, who writes for New Yorker Magazine, says of Gwande: “I am continually amazed by the clarity of his vision, and his ability to change people’s actions by changing their perceptions.”

In 2009, Gwande raised eyebrows in his book, Checklist Manifesto, in which he advocated checklists as a way to prevent costly medical mistakes resulting in litigation and patient death.

Gwande believes medical checklists are just as important as those airlines commonly use today. They’re routine and highly effective in eliminating errors.

Medical errors have been chronic. In 2016, an eight-year study by researchers at Johns Hopkins University found that medical errors account for 10 percent of all U.S. deaths and are the third highest cause of death in our nation behind heart disease and cancer.

Gwande is focused on what he considers wasteful spending, which is estimated to be $765 billion a year—25 percent of all U.S. health care spending.

Finally, he’s looking to reform the way our system views end-of-life treatment. That’s particularly important to our growing number of retired citizens.


Don Brunell is a business analyst, writer, columnist, and retired president and CEO of the Association of Washington Business. He now lives in Vancouver, Wash., and can be contacted at 


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