Gerd Gigerenzer argues that risk literacy and reduced healthcare costs go together in his book Risk Savvy. By increasing risk literacy we will help both doctors and patients better understand how behaviors contribute to overall health, how screenings may or may not reveal dangerous medical conditions, and whether medications will or will not make a difference for an individual’s long-term well being. Having both doctors and patients better understand and better discuss the risks and benefits of procedures, drugs, and lifestyle changes can help us use our healthcare resources more wisely, ultimately bringing costs down.
Gigerenzer argues that much of the modern healthcare system, not just the US system but the global healthcare system, has been designed to sell more drugs and more technology. Increasing the number of people using medications, getting more doctors to order more tests with new high-tech diagnostic machines, and driving more procedures became more of a goal than actually helping to improve people’s health. Globally, health and the quality of healthcare has improved, but healthcare is often criticized as a low productivity sector, with relatively low gains in health or efficiency for the investments we make.
I don’t know that I am cynical enough to accept all of Gigerenzer’s argument at face value, but the story of opioids, the fact that we invest much larger sums of money in cancer research versus parasitic disease research, and the ubiquitous use of MRIs in our healthcare landscape do favor Gigerenzer’s argument. There hasn’t been as much focus on improving doctor and patient statistical reasoning, and we haven’t put forward the same effort and funding to remove lead from public parks compared to the funding put forward for cancer treatments. We see medicine as treating diseases after they have popped up with fancy new technologies and drugs. We don’t see medicine as improving risk and health literacy or as helping improve the environment before people get sick.
This poor vision of healthcare that we have lived with for so long, Gigerenzer goes on to argue, has blinded us to the real possibilities within healthcare. Gigerenzer writes, “calls for better health care have been usually countered by claims that this implies one of two alternatives, which nobody wants: raising taxes or rationing care. I argue that there is a third option: by promoting health literacy of doctors and patients, we can get better care for less money.”
Improving risk and health literacy means that doctors can better understand and better communicate which medications, which tests, and which procedures are most likely to help patients. It will also help patients better understand why certain recommendations have been made and will help them push back against the feeling that they always need the newest drugs, the most cutting edge surgery, and the most expensive diagnostic screenings. Regardless of whether we raise taxes or try to ration care, we have to help people truly understand their options in new ways that incorporate tools to improve risk literacy and reduce healthcare costs. By better understanding the system, our own care, and our systemic health, we can better utilize our healthcare resources, and hopefully bring down costs by moving our spending into higher productivity healthcare spaces.