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The Medical Professionalism Blog

Medical Professionalism and Conserving Resources – Just How Much is a Trillion Dollars?

In recent weeks, headline news has been reporting on the battle to curb the federal debt.  What does this have to do with medical professionalism?

The federal government must borrow forty cents of every dollar it spends.  In health care, it needs to borrow from China and other lenders to reimburse doctors, hospitals and other providers who bill federal programs.

The government’s debt totals $14.3 trillion.  It is hard to fathom how much money a trillion dollars is.  Here’s one way to grasp the magnitude:

If I paid you, reader of this blog, $1 million every day since the year 1, or $1 million a day for 2,011 years, this would not tally to a trillion dollars.  Multiply this by 14, and that’s how much debt the federal government owes its lenders.

Congress must vote in the next three months to raise the debt ceiling so the Treasury Department can borrow even more money – because the debt keeps growing.  If it is not permitted to borrow more, the federal government will default and join the ranks of Greece, Portugal and Ireland.  The U.K. avoided default by unprecedented cuts in government spending.

I applaud the American College of Physicians (ACP) for its statement earlier this year, “How Can Our Nation Conserve and Distribute Health Care Resources Effectively and Efficiently?”.  Physician leadership is needed to help fix the unsustainable growth in health care spending so that patients’ interests are paramount.

The ACP said: “Physicians have… a responsibility to use health care resources wisely and responsibly. Resource allocation decisions also must be made at the national or systems level on how to control costs fairly and effectively for the health care system.”

I think that an important place to start is overtreatment.  The National Priorities Partnership, convened by the National Quality Forum, identified areas of medical care that are overused.

By eliminating care that does not add to the health of patients, and which can cause more harm than good, precious resources can be used to help people live healthier, longer lives.

The future of our country depends on us digging ourselves out of this financial hole.  We have no time – or money – to waste.


rosemary gibsonRosemary Gibson led national quality and safety initiatives at the Robert Wood Johnson Foundation for 16 years and was chief architect of its strategy to mainstream palliative care in hospitals.  She is author of The Treatment Trap, a book on overtreatment, and Wall of Silence: The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans, a book that puts a human face on the IOM report, To Err is Human.  She serves as Section Editor of the Archives of Internal Medicine series, Less is More.


2 Comments to Medical Professionalism and Conserving Resources – Just How Much is a Trillion Dollars?

  • e-Patient Dave's Gravatar e-Patient Dave
    May 26, 2011 at 10:31 am | Permalink

    Great post! And great to see you here, Rosemary!

    You inspired me to dig out a visualization of the incomprehensible “trillion,” which I found years ago (oddly) on a site for web developers. Here it is.

    • May 26, 2011 at 2:07 pm | Permalink

      That’s a great visualization. And yes, we need physicians who are looking out for patients’ interests to be engaged in this.

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