” Incredible. Life expectancy in the US is now 80, it used to be 45 in 1900.”
I’ll bet life expectancy has improved primarily because of drugs and procedures that are now relatively cheap, so this statement of yours does not explain our high medical costs.
Your blaming of insurance companies doesn’t ring true either. My insurance company knocks off enormous chunks of the doctor’s “sticker” prices. Not that I think insurance companies are the good guys.
I’d say the enormous costs are caused by two things: so-called new drugs and equipment that are priced high because “the manufacturers need to get back their research money” or because the drugs and equipment are often applied to a patient for the rest of his life. His or her life or in some cases comfortable life is put on a very expensive life support.
The author of that Time article aimed our curiosity in the right direction: don’t ask who’s going to pay the bills, ask why the bills are so high.
The least you could do is give us insight into where the high pricing comes from, and also show us that you understand that we are spending more on our medical care than is healthy for our society, and that you might even have ideas for reducing it.
Also, please explain why (assuming it’s true) that most other countries have the same life expectancy as ours but spend far less on medical care.
I agree with some of your ideas.
But you say insurance should be “a means of amortizing a rare and unexpected expense for an individual”. But as people age the medical reasons for the expenses aren’t rare or unexpected, and those medical expenses often continue for the rest of their lives.
A drug that thousands of people must take for the rest of their lives simply can’t be priced at thousands of dollars per year.
The information I need is exactly what that Time author said: to understand where the money goes. For instance, if a doctor get $4000 to do a breast biopsy that take 20 minutes, what is it about that procedure that costs $4000.
If a person is in the emergency room for a few hours and get a $10,000 bill, where did the money go? That’s what we ordinary people would like to know: specifically where does the money go.
The real money being made on health isn't in the doctors office, it is in the pharma companies.
For a look into the future at what will be a wonderful medical system I’ve always appreciated Solzhenitsyn.
Especially the short story “The Right Hand”
“The Right Hand” features a homeless man who, possessing only a decades-old commendation for “counter-revolutionary service,” is neglected medical treatment.
The way in which he is blown off is heartbreaking.
His major work dealing with socialized healthcare is
“Cancer Ward”.
Here’s a quick summary I found online:
The story takes place in the men’s cancer ward of a hospital in a city in Soviet Central Asia. The patients in Ward 13 all suffer from cancer, but differ in age, personality, nationality, and social class (as if such a thing could be possible in the Soviet “classless” society!). We are first introduced to Pavel Rusanov, a Communist Party functionary, who enters the hospital because of a rapidly-growing neck tumor.
We soon learn, however, that the book’s central character is Oleg Kostoglotov, a young man who has recently been discharged from a penal camp and is now “eternally” exiled to this particular province. Only two weeks earlier, he was admitted to the ward in grave condition from an unspecified tumor, but he has responded rapidly to radiation therapy. Among the doctors are Zoya, a medical student; Vera Gangart, a young radiologist; and Lyudmila Dontsova, the chief of radiation therapy.
Rusanov and Kostoglotov respond to therapy and are eventually discharged; other patients remain in the ward, get worse, or are sent home to die. In the end Kostoglotov boards a train to the site of his “eternal” exile: “The long awaited happy life had come, it had come! But Oleg somehow did not recognize it.”
Commentary
Solzhenitzyn himself was released from a labor camp in early 1953, just before Stalin’s death, and was exiled to a village in Kazakhstan. While incarcerated, he had been operated on for a tumor, but was not told the diagnosis. He subsequently developed a recurrence, received radiotherapy in Tashkent, and recovered.
In The Cancer Ward Solzhenitzyn transforms these experiences into a multifaceted tale about Soviet society during the period of hope and liberalization after Stalin’s death. Cancer, of course, is an obvious metaphor for the totalitarian state. The novel also provides an interesting look at mid-century Soviet medicine and medical ethics. Of course, the paternalism evident here (e.g. lack of truth-telling and informed consent) was also characteristic of American medicine in the 1950’s and remains an important concern in professional ethics.
The novel also explores the personal qualities and motivation of physicians, and the issue of intimate relationships between doctors and patients. Probably the book’s strongest points are its insight into human nature and the believability of its characters.