Why is health care so expensive? And what is the solution to lower the price? These have been the main topic of debate in the news and politics over the last six months.
It's time for a little history lesson. Not so long ago, healthcare was not as good as it is now. Pennicillin was not discovered until the first half of the 20th century. Treatments for diabetes came along later. Leaps and bounds have been made in the areas of medical technologies, drugs, and even sanitation. Because of all this, people are living longer. People with diseases that were once deadly now live and require ongoing treatments. Is this a bad thing? Not at all.
In addition to longer (but not necessarily healthier) lives, there are more of us to take care of. The baby boomer generation has aged, and now the largest group in the population today is also the group that requires near-constant medical attention.
The smaller population groups are asked to provide the care in the forms of doctors, nurses, pharmacists, etc. They are asked to assist financially. There are just not enough of us to go around.
Here we have a simple case of demand outstripping supply. When that happens, there is a shortage, and costs automatically rise.
Now, if we wanted to lower costs, we need to encourage more people to enter the medical field. And we probably need to stop research and development. Let's face it, once a cure has been found, everyone thinks they are entitled to it. So the simple solution to lowering medical costs would be to stop finding ways to save lives. (I offer this up as mere satire).
Another reason for high costs is the cost of research and development itself. Look at drugs. People complain about the high cost of a miracle drug that is saving their life. No one complains about the miracle. Drugs become generic so quickly these days, that pharmaceutical research companies have to mark up the price of their drugs 1,000% or more just to get by. For every drug that is marketed, many are dropped from studies. Each drug requires years and years of development and testing on hundreds of subjects.
Should the price of prescription drugs become more affordable, what I mentioned earlier will automatically happen - drug makers will simply give up finding new drugs. Yes, they will lower the cost of their drugs, but what we have now is what we will always ever have. And though the people who are being helped with the miracle drugs can now pay less, those with diseases not yet cured will never be helped.
Someone suggested that the government take research and development away from the companies, so that the companies could lower the prices without harming innovation. I think this is a bad idea for many reasons. First of all, the government is not efficient. Without being profit motivated it is, well, not motivated. We have seen the success of leaving research projects in the hands of the people. For instance, where space is concerned, private developers have picked up where NASA left off. Second, prices would still be high. We would no longer be paying them for prescriptions but to fund the research and development projects. Ultimately, then, this would be a tax on healthy people. We would pay higher taxes to fund lower prescription drugs for those who are unhealthy and already taking them. Finally, the government is not scrupulous. I have little faith in a government to avoid unethical experiments. It is true that businesses may perform them now, monitored by the government. However, if the government suddenly found itself with the power to research, it would start to bend the envelope further and further, and this time there would be no watchdog to stop it.
Another reason costs are so high are the lawsuits people file against medical practitioners. Here we may see one of the areas for greatest cost-cutting if applied correctly. Medical lawsuits, and most lawsuits for that matter, have blurred the lines of innocence and responsibility. No longer are doctors allows human errors - perfection is required or else millions of dollars may be paid out. Hindsight is 20/20, and lawsuits thrive on Monday morning quarterbacking. For this reason, doctors order excessive tests that are not necessary, just to make sure they don't miss something.
To cut these costs, tort reform is a good place to start. Another is with the people. Instead of having 10 tests performed when we go to the doctor with a headache, we should talk to the doctor and take his advice. Find out what the tests he suggests test for. Find out the odds that you have that disease. Find out what the worst case scenario outcome of having that disease go undiagnosed is. Ask for medicine that treats the problem, not just the symptoms. And above all, don't sue!
Now, I'm not saying that it's bad to sue a doctor who leaves his glove in a loved one who consequently dies. Or who amputates the wrong arm. However, even here we should be rational. Will a lawsuit bring back your sister? If it was your husband who was the bread earner, you may need the money to get by now. What do your career prospects look like now that you are armless? How much do you need to get by? We don't need to award multi-multi-million dollar lawsuits just because a doctor makes an honest mistake.
Finally, healthcare is expensive because we, the American people, are paying for it. Ever year billions of dollars of taxpayer money go to fund Medicare and Medicaid. Programs like these allow low income Americans to waltz into a doctors office any time they want - if their child coughs. While millions of other Americans stay at home with the sick kid and wait it out, either because they cannot afford the doctors visit, or because they are being responsible. In this regard, someone who only makes a few thousand dollars more than a Medicaid recipient is many times worse off than the latter and is being penalized for being wealthi-er.
If people on Medicaid were forced to pay any sort of copay, even a relatively small one, for doctors visits, it would free up doctors for other patients, earn back a small portion of the cost, and force people to consider responsibility in determining what warrants a doctor's visit.
These are things to consider when having a healthcare debate, because these issues are not easy to solve, and they may not actually need solving. Healthcare, like any other part of society, is a free market. If insurance premiums rise, it is because costs or demand rise. If Healthcare is 1/6 of our economy, it is because that is what people choose to find important. There is not an easy solution to the high costs, but there doesn't necessarily have to be. Eventually supply will catch up and if it does not, people will learn to accept a lower quality of healthcare. There is nothing wrong with that - people have survived on this planet for thousands of years with much less than we now know.
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