Will the health care worm turn?
Warren Buffett says health care costs are like a tapeworm on the American economy.
Medical experts say: We should be so lucky.
The famed investor known for his folksy wit drew the tapeworm analogy in late January when explaining why he’s joining forces with Amazon and JPMorgan Chase in a high-profile effort to tackle the intractable problem of rising expense for health care.
“The ballooning costs of health care act as a hungry tapeworm on the American economy,” Buffett said in a release announcing the effort to bring technology fixes to health care, with an eye on controlling costs.
The reference captures how health costs can look like a parasite that never stops growing, doctors agree. But, alas, the metaphor suggests too easy a solution.
“If you know you have tapeworms and you have a specific treatment available, that’s great,” said Dr. Anupam B. Jena of Harvard Medical School via e-mail. “But in health care, we know we have tapeworms, but it’s really hard to (a) find out where those tapeworms are ... and (b) we don’t have good, targeted ways to reduce that spending.”
Tapeworms are an intestinal parasite that can be found on any continent, said Dr. James Abraham, a gastroenterologist with University of Minnesota Health. When people think of tapeworms, they are usually reflecting on a relatively uncommon form where parasite eggs penetrate into the muscle tissue fibers of fish.
If the fish is raw, undercooked, not properly frozen or not sourced well, then the egg could be ingested by a human host. The head of this tapeworm locks in the end of the small intestine, and grows in segments through a valve into the colon.
The longest one reported, Abraham said, was more than 30 feet long.
“That’s my assumption of what Warren Buffett was thinking of,” he said. “They get very long, but they kind of get wound around themselves.”
Much more common is the “dwarf tapeworm,” which is very small, Abraham said. In general, intestinal worm infections don’t produce symptoms, he said, and they often are found only because doctors are looking for other problems.
Treatment typically involves medications that act fast — so fast, in fact, that CEOs could only hope for such a cure when it comes to health costs.
“Most parasitic infections with these tapeworm types usually can be cured — literally cured — with one dose,” Abraham said. “Of all the things in modern medicine, the treatment of tapeworms is like the closest thing that we have to a magic bullet.”
The tapeworm metaphor works insofar as health care spending consumes a large and growing share of the nation’s gross domestic product, said Jena, the Harvard physician. But from there, the comparison gets tough.
“Tapeworms offer no value to patients, as far as I can tell, whereas health care spending does,” Jena wrote. “The care question is how to find those areas of health care spending that don’t offer good clinical value to patients and eliminate those components.”
Larry Levitt, a senior vice president with the California-based Kaiser Family Foundation, calls the analogy “very colorful, but maybe a tad off,” since growth in health care costs has been relatively slow in recent years.
Plus, tapeworms are usually very small relative to their host, whereas health care is now one-fifth of the U.S. economy, notes Martin Gaynor, a health economist at Carnegie Mellon University.
But to Buffett watchers, the tapeworm analogy might simply indicate the problem is being taken seriously by the man dubbed the “Oracle of Omaha.”
Buffett has previously likened inflation and troubles with pension funding to tapeworms on the economy, prompting the Wall Street Journal to report of the new plan: “Warren Buffett’s favorite metaphor has once again infested the news cycle.”
And at the Mayo Clinic’s parasitology lab, director Dr. Bobbi Pritt said the metaphor nicely captures how tapeworms are a constant drain on the system.
Tapeworm infections are relatively uncommon in the U.S., Pritt said, but they’ve made quite a few appearances over the years on a blog she writes called “Creepy Dreadful Wonderful Parasites.”
A blog item last week, in fact, describes a patient who shed a tapeworm in small segments — and includes video of one segment that was still moving.
“Most people can relate to the idea of a parasite living in your intestine and taking your food from you,” Pritt said via e-mail.
“The cost of our health care system has truly gotten out of control, and now takes away a significant portion of the money that people make,” Pritt wrote. “We need a simpler system that will provide basic essential health care for everyone.”
Christopher Snowbeck • 612-673-4744 Twitter: @chrissnowbeck