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Us in this study in The New England Journal of Medicine says that we should always -- the continued growth and job creation and health care.
Now the woman who co wrote the study -- professor Catherine baker joins us now from Boston welcome doctor baker.
You know a lot of for having -- you know every time I get the jobs report I -- -- you see that health care aligned in it's always robust numbers and you say golly.
How bad -- -- the economy be if it wasn't for that one minutes but you say maybe we're reading that wrong.
Well the goal of health care spending isn't to produce health care jobs it's to produce health.
-- we think that health care spending more fiction so that we are producing more health.
With fewer people and fewer -- -- that would be a good thing we can use those people in resource is to produce other effects.
Okay you know -- you know of course when you talk about that you can actually sets a microcosm for the overall economy.
You know not necessarily the need for more money or just wiser spending this but.
What would you spend the money on in other words what what -- should we be re directing our our attention.
Well the goal of the economic.
Planning that you have in mind is really to drive resource is towards the highest value years and that's really hard to decide ahead of time from a bureaucrats desk.
Brother we brother set up a system.
We're dollars go to high value used because we're paying for health care smartly -- paying for other things in the economy smartly and -- the dollars will flow to where they produce the most value.
Very quickly the doctor make -- -- Schapiro hasn't the increase in jobs actually been at the lower level we're talking about home health aides and not even nurses but people who.
Tend to people who are now elderly we have a growing population of elderly not necessarily a bad thing.
Absolutely not necessarily a bad thing the goal is to set up a system where we get people the best help from the longest lives that we cat.
And that might be through more home health fades through more general practitioners through fewer specialists through fewer hospital administrators.
It's hard to know ahead of time until you set incentives through the payment structure so that people can use their -- -- -- get a lot of here that the high value -- that.
Problem right now if that's not always the case.
Doctor breaker you know that this has been a tough nut to crack you know I've been in hospitals where I've seen computer systems that look.
Like you know the original video game machines -- outlook.
How do you get these administrations that you're talking about that the changes behavior how did you actually and get this done.
Well that could start with payment reform through Medicare so that we're paying for high value care not just more care it could also continue -- payment reform in the private sector.
What we promote high value insurance that pays more for care that produces more.