Wednesday, September 30, 2009

Rise in Healthcare: Hollow Argument

I have been listening to the healthcare debate with some interest. I mean, this proposed legislation may be the most expensive entitlement program in the history of the United States.

One of the key arguments is that healthcare expenses continue to rise faster than other goods and services. You know, that argument may or may not be a good argument for the healthcare bills currently undergoing review.

Consider this simple example: When I was a child, I knew someone who injured his foot while mowing the lawn. The foot was badly injured, and because of the extent of the injuries, the foot was amputated. I was chatting with an online friend whose husband was badly injured in a similar fashion, and he is undergoing several reconstructive surgeries. The foot will be saved and functioning. And this summer, I was on a ship, doing the tourist thing. They were talking about the various compartments and what the sailors did in the compartments. One of the things they showed us was a saw, used in shipboard amputations in the 18th and 19th centuries.

It occurs to me that we have made stride in the healthcare we can expect. Two hundred years ago, two strong male nurses held you down while a doctor quickly sawed off the limb. And most of the time, you survived the ampulation. There was no anesthesia, antibiotics and the like, and so the whole procedure was relatively cheap. Twenty years ago, unless you were in some of the best medical centers in the world, you received anesthesia but the foot still was removed. You received antibiotics and your chance of survival was near 100 percent. And the procedure was more expensive. Now with the vascular surgeons and graft specialists, specialized drugs, etc., you are much closer to being made whole, after several surgeries and physical therapy. And the cost rises. But the number and quality of services also has risen.

When people talk about prices rising, one has to consider that over time, the nature of services or goods may change as well, and just looking at cost increases is not the way to go.

Oh, and besides, if you want to talk about escalation of prices – why is that a primary reason to get the government involved in the first place? We live in a free market, and we don't want to trust a free market.

I am not saying we should or should not support healthcare reform. What I am saying is that price escalation should not be listed as a reason in any politician's position paper.


Anonymous said...

Leesa your point is valid to a degree, however the debate is not simply that health care costs have increased it is that medical insurance premiums have increased some 119% over the last decade while wages have stagnated or fallen during the same time for the vast majority of Americans. According to the The National Coalition on Health Care, "Employer-based family insurance costs for a family of four will reach nearly $25,000 per year by 2018 absent health care reform." This is only for those who have employer based medical insurance.

Those without any insurance (which are rising) have only Emergency rooms or go without treatment as options. Of course the oldest and the poorest have Medicaid and Medicare so they are covered.

I appreciate your opinions on this issue, but cost increases are not solely due to advances in medicine and without some restructuring it will eventually bankrupt the country.

Thank you for your blog

Mike - NC

Anonymous said...

I agree. The problem isn't solved getting the govt. involved. We have govt. health care and it sucks. Ask my mom. It's lousy and most doctors don't accept it. Why would "new" govt. health care be any different. Fix the problem, don't create new ones.

Malach the Merciless said...


Anonymous said...

I'd like to comment on this. In 1994 my mother suffered congestive heart failure. She was rushed to the emergency room by aid car. The doctor who treated her told me that 20 years earlier (1974) she would have never made it to the emergency room.

Mom spent two days in intensive care. Have you ever seen an ICU? The staff to patient ratio is very high and they have about a gazillion dollars with of equipment at their fingertips. Two days in the ICU is very expensive.

We live in an age of miracles, and miracles cost a lot of money.

People say we should spend more money on education to get better outcomes. Why isn't the same true for medicine?


Gary Baker said...

"People say we should spend more money on education to get better outcomes. Why isn't the same true for medicine?"


You make an excellent point, though I don't think the one that you are intending. Studies repeatedly show that adding more money to education does not improve education. When adjusted for inflation, the cost of a public school education has doubled since the seventies, and results have plateaued overall, with some areas in a horrible state. This is largely due to the politicization of education by constituencies that do not have education as the major goal. These include teacher's unions, local governments that count on political donations, and a lack of parents, teachers, and administrators to use methods that have been proven to work. All of this leads up to a very important question:

If government schools are largely ineffective at addressing systemic problems because that will offend constituencies, what makes you think they will do better with health care?

Seriously. In the past, the standard answer to a government school that was performing below standard was to demand, and receive, more money. Is that the kind of model that we want to carry into health care?

I don't think of myself as unreasonable, but to simply assert that the government can do a better job with health care really puzzles me since I can't think of a single institution that they run more efficiently than the private sector. If anyone out there could enlighten me, I would love to hear it.

Additionally, the last survey I read shows that the profit margin for the health insurance industry is 2%. If the average small businessman tried to live on that, they would starve. If people think that the insurers are gouging the public, they are missing the mark.

Again, as Rich says "Miracles cost a lot of money." Nothing that man can come up with is going to change that. What this debate is really about is how many miracles each person is entitled to at everyone else's expense. If you honestly believe that everyone should have access to unlimited health coverage at public expense, I invite you to stop off at the nearest hospital and give them everything you have.

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