"It is going to take courage to name and address the large portion of American healthcare that simply does not help," Berwick said.
Another "monster," he said, is excess profit, which companies are legally allowed to make through marketing approvals of drugs. One, hydroxyprogesterone, a drug to prevent premature labor and low-birth-weight babies, costs payers such as Medicaid as much as $25,000 for a course of treatment, instead of the $300 the drug would cost if it were still allowed to be sold in its generic form.
One of the attendees, physician pathologist Lisle Eaton from St. Peter's Health Partners in Albany, NY, expressed a similar view, but said most physicians he knows, especially oncologists, "have their heads buried in the sand" about the problem.
For example, he said in between sessions, for oncologists, the desire is to treat with drugs, even if the drugs are extremely expensive, and even if these same drugs "may not have the best track record" for helping these same patients, and which carry serious side-effects as well.
"Nevertheless, they march down that road. I'm not saying they're not good doctors or they don't care, but sooner or later, we have to see quality and cost savings can go hand and hand."
In any year, attending the IHI National Forum is like—to use a cliché—drinking from a fire hose. And this year was no different, with an impossible number of inspiring ideas for dozens of stories and columns.
I hope to capture many of them in this space in the weeks and months to come. Stay tuned.