Aging population, treatment demands stress health care system

The nation's health care system doesn't look good. It is contentious, litigious and over-regulated—in need of major changes.

(Photo courtesy U-M Health System)

"In television parlance, our health care system needs an 'Extreme Makeover,' says Dr. Robert Kelch, executive vice president for medical affairs and U-M Health System (UMHS) CEO.

The aging population and increasing demand for new treatments are two reasons the national health care system will become more inadequate and troublesome unless steps are taken to make it socially responsible, he says. In addition, universal health coverage is needed—which Kelch believes will happen in some form—to assist many people who are uninsured and underinsured.

"There's a tension between what we can do for an individual and what we should do for the herd. This will bring about more social questions that we have to address," says Kelch, who will focus on this topic when he delivers the Winkelman Lecture at 3:30 p.m. April 4 in the School of Social Work Educational Conference Center, Room 1840. His talk is titled "A Socially Responsible Health Care System in the Era of Longevity Genes."

Kelch oversees the three components of UMHS: the Hospitals and Health Centers, including three nationally prominent hospitals and more than 17,800 employees; the top-ranked Medical School, which receives $300 million in annual grant support and has more than 2,100 faculty and 1,500 students and trainees; and the M-CARE managed care organization, which has 203,000 members.

Research and medicine have led the way to people living longer. In 1900, life expectancy was 47 years. Six years ago, it was 77 years. By 2020, it will exceed 100 years. Kelch says researchers have studied a compound called resveratrol—found in red wine—that increased the longevity of fruit flies by 30 percent. Now researchers are looking at a similar compound as they study mice.

A longer life expectancy is good news for the first Baby Boomers as they turn 60 this year. They are better health care consumers than their predecessors, better educated—including about health care—and more active, Kelch says. But they also demand more care with their "fix it" mentality. The United States will spend nearly $2 trillion on health care in 2006—15.6 percent of Gross Domestic Product, more than any other major expenditure and more per capita than anywhere in the world.

"The money we're devoting to health care isn't spread evenly, but is concentrated on a small percentage of the overall population," says Kelch, a nationally known pediatric endocrinologist specializing in basic and clinical research on neuroendocrine regulation of human growth and sexual maturation. "It also isn't devoted to prevention, but rather highly complex, often end-of-life care."

One problem Kelch sees is the continuing surge in annual administrative costs, which outpace total health expenditures. This trend can change with a simplified health care system that reduces regulation and overhead, he says.

The Winkelman Lecture Series is made possible by a donation to the School of Social Work from the Winkelman brothers—Stanley, John, Frederick and Henry—in memory of their parents, Leon and Josephine Winkelman. The lecture is a forum for the presentation and discussion of emerging knowledge from the social and biological sciences and the helping professions.