Health Care Costs

If you want to be more knowledgeable about health care than 99.5% of the US population, read this. Paul Ginsburg is one of the better health care policy experts in the country. This is, in part, because he has an affinity for facts and data.

There are a number of studies and rankings that identify the US as having a sub-par health care system. We spend more than any other country, by a wide margin, and still have millions of uninsured and worse outcomes. Some of the measures are misleading. Life expectancy for one is skewed in the United States due to higher murder rates and traffic accidents. No that those are not problems, but they really don't allow for any conclusions about our health care system. Further, a number of the studies that rank the the US health care system poorly do so because they consider how accessible the system is to everyone. Again, it may be an important issue, but it doesn't necessarily tell you anything about the relative quality or value of the health care system.

That said, the US heath care system has major issues. As the Ginsburg report notes, cost is a major one. Really, it's the major one. We consume massive amounts of care that are unnecessary. We devalue primary care and promote high cost interventions. We reimburse providers based on the volume of care they provide with zero regard to quality or need. We fund drug research for the rest of the world. Most of the "reform" efforts being discussed deal primarily with access. That is an important issue. It pales, however, in comparison to the issue of cost because the cost is not sustainable. Health care now consumes slightly better than 16% of GDP and my guess is that it will hit 20% at some point. If you want to know why wages are stagnant, you don't have to look too much further. Pay increases are granted in the form of health benefits every year and, based on the growth of premiums, wages have been increasing substantially. But nobody wants that kind of pay increase. I'll post more about this later. The takeaway is that any politician or reformist or advocate who isn't talking about cost isn't talking about what matters.