As the 2024 presidential election draws nearer, nearly 75% of Americans report healthcare costs as a primary financial worry according to a new study from KFF. Americans have every reason to feel this way: over the last five decades per capita healthcare spending has increased from $353 in 1970 ($2,072 adjusted for inflation) to $13,493 today.

根据肯德基（KFF）的一项新研究，随着2024年总统大选的临近，近75%的美国人将医疗保健费用列为主要的财务担忧。美国人有充分的理由这样想：在过去的50年里，人均医疗保健支出从1970年的353美元（经通货膨胀调整后为2072美元）增加到今天的13493美元。

But care quality has not increased by the same rate – rather, patients are simply paying more today for the same “one-size-fits-all” treatments. .

但护理质量并没有以同样的速度提高，相反，患者今天只是为同样的“一刀切”治疗付出了更多。。

Rising costs and poor quality, however, are not the result of this administration or that one. They are a function of deeper problems endemic to the American healthcare industry itself.

然而，成本上升和质量差并不是本届政府或本届政府的结果。它们是美国医疗保健行业自身特有的深层次问题的函数。

Added attention to the cost of care gives healthcare stakeholders the opportunity to step back and evaluate American healthcare as a whole. It is incumbent on us to think through system level changes and reshape the future of care delivery in this country.

对护理成本的额外关注为医疗保健利益相关者提供了退后一步并评估整个美国医疗保健的机会。我们有责任思考系统层面的变化，重塑这个国家护理服务的未来。

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With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?

随着人工智能的兴起，医疗保健领域可能会出现哪些知识产权纠纷？

Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.

Munck Wilson Mandala合伙人格雷格·豪森（GregHowison）在回答电子邮件中提出的问题时，分享了他对人工智能、IP、连接设备及其产生的数据产生的一些法律后果的看法。

Fortunately, home-based healthcare paradigms like hospice, that have long been recognized as the least institutionalized and profit-driven segments of the healthcare industry, offer a model for a return to healthcare sanity.

幸运的是，像临终关怀这样的以家庭为基础的医疗模式，长期以来一直被认为是医疗保健行业中制度化程度最低和利润驱动程度最低的部分，为恢复医疗保健健康提供了一个模式。

American healthcare is beset by skyrocketing costs that force many patients to choose between their health and their financial stability. The statistics are staggering: Healthcare is the primary reason that Americans file for bankruptcy. Over half of Americans––57%––report having had some medical debt over the last five years..

美国医疗保健受到飞涨成本的困扰，迫使许多患者在健康和经济稳定之间做出选择。统计数字令人震惊：医疗保健是美国人申请破产的主要原因。超过一半的美国人（57%）报告说在过去五年中有一些医疗债务。。

What’s more, the United States spends much more on healthcare per person than peer nations; some studies suggest we spend twice as much. As the most prosperous, innovative country on Earth, our healthcare system should be the best. Instead, it’s one of the worst amongst wealthy countries.

更重要的是，美国人均医疗保健支出远高于同行国家；一些研究表明我们的花费是原来的两倍。作为地球上最繁荣、最创新的国家，我们的医疗体系应该是最好的。相反，它是富裕国家中最糟糕的国家之一。

Numerous factors contribute to the escalating costs of traditional American healthcare systems. One leading cause is that many healthcare providers have gone all-in on physical infrastructure, building giant campuses that cost hundreds of millions of dollars to build and maintain, often relying on federal subsidies for construction and modernization. .

许多因素导致美国传统医疗保健系统的成本不断上升。一个主要原因是，许多医疗保健提供者全力以赴建设物理基础设施，建造和维护耗资数亿美元的巨型校园，通常依靠联邦政府的建设和现代化补贴。。

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A Personalized Approach to Medication Nonadherence

个性化的药物不依从性方法

At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.

在今年早些时候的Abarca Forward会议上，德勤董事总经理乔治·范安特卫普（GeorgevanAntwerp）讨论了健康的社会决定因素和个性化的会员体验如何改善药物依从性和健康结果。

But huge complexes are not the only option. In fact, the home and community based care model shows the way forward for a new kind of healthcare.

但大型综合体并不是唯一的选择。事实上，以家庭和社区为基础的护理模式为新型医疗保健指明了前进的方向。

Patients often prefer to be treated at home rather than shuttling back and forth to hospitals, clinics, doctor’s offices and other care facilities. The comfort of the home environment alleviates anxiety and eliminates the stressful time spent in traffic, looking for parking and navigating unfamiliar medical settings.

患者通常更喜欢在家接受治疗，而不是往返于医院、诊所、医生办公室和其他护理设施。舒适的家庭环境缓解了焦虑，消除了在交通、停车和不熟悉的医疗环境中度过的紧张时间。

It allows patients to receive care in familiar surroundings with the support of their loved ones. .

它允许患者在亲人的支持下，在熟悉的环境中接受护理。。

Rates of telehealth usage corroborate these preferences. Before the Covid-19 pandemic, most providers did not offer telehealth options, but once close physical proximity became hazardous, providers began to offer it. One study found that telehealth visits increased from 840,000 in 2019 to an astonishing 52.7 million in 2020.

远程保健的使用率证实了这些偏好。在新型冠状病毒肺炎大流行之前，大多数医疗服务提供者都没有提供远程医疗服务，但一旦近距离接触变得危险，医疗服务提供者就开始提供远程医疗服务。一项研究发现，远程医疗就诊人数从2019年的84万人次增加到2020年的5270万人次。

While numbers have fallen somewhat since their peak in 2020, rates of telehealth use now are exponentially higher than they were pre-pandemic. .

虽然自2020年达到峰值以来，数字有所下降，但远程保健的使用率现在比大流行前成倍提高。。

Just as importantly, the at-home care model makes price easier to control by reducing expensive real estate and physical infrastructure costs. One study found that home-based programs effectively reduced complications while cutting the cost of care by 30%. Another found that mean cost of care was 38% lower, and that, compared with patients in traditional campus-based facilities, at-home patients spent a smaller proportion of the day sedentary and were readmitted less frequently. .

同样重要的是，居家护理模式通过降低昂贵的房地产和物理基础设施成本，使价格更容易控制。一项研究发现，以家庭为基础的计划有效地减少了并发症，同时将护理成本降低了30%。另一项研究发现，平均护理成本降低了38%，与传统校园设施中的患者相比，在家患者一天中久坐的比例较小，并且重新入院的频率较低。。

Detractors point out that some complex procedures can only take place in a hospital environment, with expensive equipment and specialized medical staff, making it infeasible to treat certain conditions at home.

批评者指出，一些复杂的手术只能在医院环境中进行，设备昂贵，医务人员专业，因此在家治疗某些疾病是不可行的。

To this I heartily agree. Specialized campuses have their place in the healthcare ecosystem and play an indispensable role in the healthcare delivery process. They should not, however, aggregate all evaluation, treatment and checkup into a single location. A major procedure should take place at the hospital; many subsequent checkups need not.

对此我衷心同意。专业校园在医疗保健生态系统中占有一席之地，在医疗保健提供过程中发挥着不可或缺的作用。然而，他们不应该将所有评估，治疗和检查汇总到一个单一的位置。主要程序应在医院进行；许多随后的检查不需要。

Yearly physicals, diagnostic tests like blood tests, routine vaccinations and counseling sessions require travel and waiting rooms, often needlessly. A great deal more healthcare can take place in the home, leaving valuable bandwidth available for specialized facilities when they are needed. .

每年的体检、血液检查等诊断测试、常规疫苗接种和咨询会议都需要旅行和等候室，通常是不必要的。更多的医疗保健可以在家中进行，在需要时为专业设施留下宝贵的带宽。。

America’s campus-based system is overbuilt and over-complicated, creating misaligned incentives. Costs are spiraling out of control. The time for small tweaks has passed. It’s time to think big, cut to the root of the problem, and find solutions. But before we reinvent the wheel, let’s look to existing models like home and community based care to give us a blueprint..

美国以校园为基础的系统建设过度复杂，产生了不协调的激励机制。成本失控。小调整的时间已经过去了。是时候大处着眼，从根本上解决问题，并找到解决方案了。但在我们重新发明轮子之前，让我们看看现有的模式，如家庭和社区护理，为我们提供一个蓝图。。

Photo: SDI Productions, Getty Images

照片：SDI Productions，Getty Images

Andrew Molosky

Andrew Molosky

Andrew Molosky is the President and Chief Executive Officer at Chapters Health System, one of the nation’s premier community-based healthcare delivery systems.

安德鲁·莫洛斯基（AndrewMolosky）是美国首屈一指的基于社区的医疗保健服务系统之一的Chapters Health System的总裁兼首席执行官。

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家庭护理

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医疗保健费用

telehealth

远程医疗

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