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Page: << Prev | 1 | 2 However, gains have been small when it comes to people who manage to make it to age 65. According to the report, lifespan for Americans 65 and older has increased by just 3.5 years -- at a per-person cost of $84,700 for each added year.
And it's unclear whether these cost-effective gains will continue. "There are storm clouds on the horizon," Cutler said. "Whether they stay away is a question."
One way to head off those clouds is to "reorient payments, not just pay for what is being done but pay for doing a better job," Cutler said. Many professional medical societies have published practice guidelines, "but three-quarters of patients are not properly managed according to those guidelines," he said.
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Experiments have started in several parts of the country to measure the quality of care provided by doctors, Cutler said. Estimates of the cost of ineffective care run as high as 20 percent to 30 percent of medical funding, he said, but "we hope we can get doctors to do the effective stuff without the ineffective stuff."
The study is "a first step toward moving to a deeper level of understanding of the value of medical spending," Rosen added.
For example, extending the life expectancy of older people is just one aspect of the value of medical care, she said. Reducing disability for older people is also important, "but we are not a nation that has measured quality of life and disability over time," the Michigan expert said.
In addition, "trends over time suggest that increases in medical spending are outpacing improvements in life expectancy," Rosen noted. "We need to focus on what areas we are getting the best value from, on diseases that have a higher impact on morbidity and mortality."
More information
There's more on U.S. medical care spending at the National Coalition on Health Care (www.nchc.org ).
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