Health Care: Recommended Reading from NPR

A lot of people are worried about how taxpayers are going to cover the cost of comprehensive health care in the U.S. And assuming that nothing about the tax system is going to change (i.e., the super rich will continue not to have to pay their fair share), I think this is a valid and justified concern.

Or listening, as it were.

NPR is doing a 3-part series on why the cost of health care in the U.S. is so high.

Which, I think is important to know about, especially in the climate of all the talk about health care reform. A lot of people are worried about how taxpayers are going to cover the cost of comprehensive health care in the U.S. And assuming that nothing about the tax system is going to change (i.e., the super rich will continue not to have to pay their fair share), I think this is a valid and justified concern.


Health care costs more in the U.S. than it does in some other places.

A quick example — not the only one but one I happen to know about — is the Mirena IUD. In the United Kingdom, the cost to the health care system is about £90; according to this exchange converter, that’s about $144US. The cost of a Mirena IUD in the United States, though, is $585.89US, $442.04 more than it costs in the UK.

If we’re going to have a comprehensive dialogue about health care reform, it’s worth looking into: a) why those overall costs are so high; b) what can be done to lower those costs. Hence the value of NPR’s series.

A couple of the contributing factors: the fee-for-service payment system and the "more is better" attitude:

Doctors exist in a fee-for-service system that encourages — and really because of the threat of malpractice and having to battle insurance companies — in some ways actually forces them to do more. More surgery. More tests. More of everything.

And while most Americans just assume that more care is good, it turns out that more isn’t always better for patients.

 

Even as someone whose chief complaint about the health care system is that it’s often not doing enough for me (by which I think I really mean that it’s not doing the right things for me), I’m a recipient of that "more is better" philosophy. I have an appointment next month with a specialist to be evaluated for possible endometriosis. One option for that evaluation is exploratory laparoscopic surgery, which may or may not detect the problem even if it’s present in my body. If there’s detectable, discrete pockets of endometrial tissue, further surgery to remove them has about a 60% chance of working long-term. Surgery, to diagnose and to treat, has both physical and financial costs. Furthermore, it’s not truly necessary in order to pursue what it is I really want: better pain management, which is something that could be accomplished much more cheaply.

So it’s something to think about. I’m not outright opposed to surgery for me — I think it makes sense to hold off on any decisions until I speak with the specialist — but I do have to ask myself, "What will this actually accomplish?"

And I think I’m very far from being alone in that. Rather, it looks like I’m part of a huge national trend with a price tag to match:

In fact, Fisher and other researchers estimate that almost one-third of the care given in our country today is that kind of care — care that isn’t really helping people.

The United States spends more than $2 trillion on health care every year. So the cost of that 30 percent unnecessary care annually? $660 billion.