I wrote several weeks ago about “healthcare by the numbers.” In this post I reported that the average healthcare spending of 50% of Americans is under $300 per person per year.That would be $93,000,000,000. The top 1% spend $90,000 per person annually.That would be $279,900,000,000.

When I asked a student interviewing for a medical school position yesterday how he felt about the changes in care delivery he gave me the “People need to take more responsibility” answer that has become popular amongst folks that believe it’s everyone else’s spending that is the problem. I have a better answer for the next student I interview:

Me: How should we fix health care delivery?

You: I don’t pretend to have all the answer but I think instead of spending A LOT of money on marginally effective care, perhaps we ought to focus on reducing duplicating services and only practicing evidence based care. That should reduce the cost incurred by the most expensive patients by 1% at least. Then we can take that $2,799,000,000 a year and spend it on bike lanes and such to keep people healthy. If we count it as “health care” it only raises the cost to the lowest 50% by $8 per year.

Me: But what about the really sick people?

You: I suspect this will not result in a lowering of their health status (and might make them live longer). It would allow all of America to STAY HEALTHY. It also would take money out of the pockets of doctors and hospitals. That would be good because I’m not in it for the money.