Cutting Health Care Costs

Clearly this trend cannot be sustained. And these government expenditures are only part of the snowballing costs of health care. This year we rejoice because in a depression/recession health care cost increases of 5-6% were only twice that of inflation. This is not cost containment.

Our conservative friends think markets would work to control health expenditures. That’s unproven and likely unworkable–see here, here, and here.

Patients are not in a position to shop health care. Finding the “best price” for emergency care and most other health care needs is simply not possible and the patient has to take whatever is available from the local supplier at the demanded price. Furthermore, health care is not like other commodities that people can take or leave as they wish. Buying a car or even a new home is an optional expenditure, health care is not. Yet health care costs/year for an individual can now approach and exceed these large expenditures.

Patient’s health care decisions reflect their anxiety, personal bias, financial status and understanding of the situation. This last factor should not be underestimated. Patients in the majority of instances cannot fully understand the risks and/or benefits of treatments and the alternatives, much less concern themselves with cost efficiency data. He/she is thus greatly influenced by physicians, manufacturers, insurers, etc., all with superior knowledge of the situation. All these advisors have extreme conflicts of interest that interfere with unbiased advice and undermine the notion of a “free health care market”–it doesn’t exist.

Medicynical note: The question is whether we have the political will to face this “music” and decide. We seem able to turn on a dime and go war, cut taxes for the wealthy and provide “tax incentives” for industry. For real people, however, we’ve become inert.

It appears our republican friends are unalterably opposed to change in the status quo that might affect the profits of their industry supporters. And the democrats, (it makes a cynic’s day) appear no more independent of industry influence.

Inaction will lead to more spending, more uninsured, more medical bankruptcy, more “free” ER use, more deaths from delays in care and a slow erosion in the general effectiveness of health care.

Somewhere between the “greatest generation” and our current one something happened. I think Pogo was probably right.


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