Here is an article from the Financial Times –

When Diane Flint visits an elderly patient on her rounds in Manchester, New Hampshire, to check on his newly attached prosthetic limb, she was regaled with tales of his shopping trips to WalMart, and of a recent fall.

“I ended up looking like a raccoon with a couple of black eyes,” David Willikens, 74, tells his nurse. “I was probably 270 pounds when I went down. Not easy to get up!

New Hampshire, a small state of only 1.3m people with an outsized number of hospitals, would seem well equipped to cope with an ageing population and patients such as Mr Willikens, whose leg was amputated in August after complications from diabetes.

But the new frontier of medicine in the state is not the hospital – it is the home, where nurses such as Ms Flint go for face to face consultations, while tending to most problems over the phone.

Ms Flint’s work is part of an experiment being repeated across the US to control health costs, an issue that is fast becoming an existential danger to US public finances. Enshrined in President Barack Obama’s health reforms, which are being phased in this year, are plans to reduce spending as well as extend insurance coverage to more Americans.

The government spent $550bn in 2012 on Medicare, which funds care for the elderly and the disabled, the third-largest budget outlay behind pensions and defence. Within two to three years, Medicare costs are projected to surpass defence spending.

That is just the start of the problem, as the programme’s trustees estimate that Medicare outlays will outpace economic growth for the next 75 years. While the rate of growth in Medicare costs has levelled off in recent years, analysts say this is most probably because of the recession, which has cut the money patients can afford to contribute to the cost of their care.

For the full story please follow this link – Financial Times