Obamacare is not going to solve the health care crisis, but a new initiative, led by a statistician, may help

29 Jun 2012

Obamacare may help protect a vulnerable section of our population, but it does nothing to solve the real problem with health care in the US: it is unsustainably expensive and getting worst worse. In the graph below (left) per capita medical expenditures for several countries are plotted against time. The US is the black curve, other countries are in grey. On the right we see life expectancy plotted against per capita medical expenditure. Note that the US spends $8,000 per person on healthcare, more than any other country and about 40% more than Norway, the runner up. If the US spent the same as Norway per person, as a country we would save ~ 1 trillion $ per year. Despite the massive investment, life expectancy in the US is comparable to Chile’s, a country that spends about $1,500 per person. To make matters worse, politicians and pundits greatly oversimply this problem by trying to blame their favorite villains while experts agree: no obvious solution exists.

This past Tuesday Johns Hopkins announced the launching of the Individualized Health Initiative. This effort will be led by Scott Zeger, a statistician and former chair of our department. The graphs and analysis shown above are from a presentation Scott has  shared on the web. The initiative’s goal is to “discover, test, and implement health information tools that allow the individual to understand, track, and guide his or her unique health state and its trajectory over time”. In other words, by tailoring treatments and prevention schemes for individuals we can improve their health more effectively.

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So how is this going to help solve the health care crisis? Scott explains that when it comes to health care, Hopkins is a self-contained microcosm: we are the patients (all employees), the providers (hospital and health system), and the insurer (Hopkins is self-insured, we are not insured by for-profit companies). And just like the rest of the country, we spend way too much per person on health care. Now, because we are self-contained, it is much easier for us to try out and evaluate alternative strategies than it is for, say, a state or the federal government. Because we are large, we can gather enough data to learn about relatively small strata. And with a statistician in charge, we will evaluate strategies empirically as opposed to ideologically.  

Furthermore, because we are a University, we also employ Economists, Public Health Specialists, Ethicists, Basic Biologists, Engineers, Biomedical Researchers, and other scientists with expertise that seem indispensable to solve this problem. Under Scott’s leadership, I expect Hopkins to collect data more systematically, run well thought-out experiments to test novel ideas, leverage technology to improve diagnostics, and use existing data to create knowledge. Successful strategies may then be exported to the rest of the country. Part of the new institute’s mission is to incentivize our very creative community of academics to participate in this endeavor.