Socialized Health Care in the USA

[kandrathe]

How much has the cost of insurance really gone up in terms of constant dollars?

As measured as a percentage of GDP it has gone up, but also with the increase of aging baby boomers it makes sense that they would spend their acquired wealth on health care as one of their major expenses. Also, no one is really looking at other commodities to compare how peoples awareness or tastes have changed over time either. People may be devoting more money to health care because they value it more these days.

How much of what is paid to the medical profession goes to support a broken tort system? How much of the medical expenses incurred by individuals are caused by unnecessary tests ordered so that doctors can cover themselves from liability?

Two good related questions. From what I've read if you equalized the US to Great Britain or Canada, the US spends significantly more because of tort. Although, I've also read that another issue with testing is that the physician who orders a test might also have a financial interest in the profitability of the testing laboratory. So, more tests means more profits for the physician who ordered the tests.

How much does the competition to have all the cutting edge technology at *every* facility add to medical costs? And how many tests using this technology are ordered to cover the cost of buying and running these machines?

Capital improvements usually are not that big a factor in operational costs. Accelerated depreciation would ameliorate the burden in a for profit organization, but the non-profit hospitals may have a harder time defraying the costs.

What I do know is simpler -- the USA has an expensive and inefficient medical system. Our infant mortality rate is terrible, our life expectancy is poor. If we didn't spend more than anyone else on medical care, that might be understandable -- but we don't.

Here is an interesting view on infant mortality vs GDP over time.

The free market had its chance, and it failed. Instead of supplying coverage for all, it focused on profits for a few. Letting people 'take care of their own' is great in principle, but it fails in practice as more and more people lack 'their own' to care for them.

I don't think the free market is getting a fair shake. The nature of health insurance and the number of people seeking health insurance has changed significantly from 1950 to today. Way back then, you'd pay your doctor bill yourself. Stringent regulations have limited the ability of different types of products to compete fairly in the market.

I was thinking about this analogy on my drive home today. Say that instead of health care, the government decided to give everyone a pollution free automobile. And, they put in a bunch of regulations requiring this automobile have all kinds of options that you may or may not use, but since we can't discriminate, every vehicle must have them all. Now, you don't have to pay a dime for this vehicle, and it doesn't matter if you drive it roughly or gently, or crash it into a wall. The government will take care of repairing it or replacing it if you total it. Do you think this would encourage conservation of the resource or rampant abuse of the resource? I just have to believe that if it is your cost to repair it, then you'd take better care of it.

So, the real question is: does a compassionate society take care of its members, or does it let them suffer for some idealized concept of 'rugged independence'?

Yes, of course we should care about each other, but the question I'm asking is should the government force "the workers", (or perhaps it would be more accurate to describe tax payers as "the productive class") to pay for everyones whim of health care, whether that be birth control pills, exercise programs for the obese, or detox programs for the inebriated.

Perhaps, more fundamental still: are we a compassionate society?

Just as we've talked about trying to bring about democracy by fiat in Iraq, why do we think we can legislate compassion with the force of law? Yes, we love our neighbors. We pay our taxes, or go to jail.