Under a banner
headline “Experts Say Medical Costs, Draining Nation’s Other Needs, Must be
Curbed” The New York Times on
We have heard
this song many times before. Everybody is talking about it but no one knows
exactly what to do about it.
The general
assumption now is that the high cost of medical care, about 10 per cent of the
Gross National Product (GNP) is bad for the country. The figure of course is
spurious because the GNP has slumped during recession so that even if the
medical costs remain stable their percentage share of the AGNP will increase as
long as production is slumping.
I think what
is long overdue is a proper analysis of the costs, instead of the whinnying
from government satraps
and their hired committees bemoaning the fact that it cost money
to give Americans the best care that money can buy. I thought that was what
this country was all about.
The article
states that five years ago Dr. Marvin Moser headed a committee of doctors who,
working under government auspices, determined that in most cases the customary hospital
diagnosis and treatment of hypertension was unnecessary and that today
outpatient treatment is the norm for that condition. Well, sad be it to tell for those of us whose tax money was squandered
on the obvious, outpatient treatment for hypertension was the norm before the
committee convened.
The article
goes on to enumerate $9,000
of hospital charges for a patient with bronchitis. Well that probably is also
fallacious. The $9,000 is what the hospital charges to arrive at a third party
per diem payment figure which is much lower. The hospitals pad their charges to
arrive at a negotiated settlement with the third party. Next time you get a
statement of charges from a hospital read it carefully. It says “This is not a
bill”. It isn’t. It’s malarkey.
The article
says that industry could pay higher wages if it weren’t for the increased cost
of health care built into their labor contracts.
That is a
misrepresentation. Industry didn’t want
to shell out any more
for wages so they built health care into their union contracts,
figuring that health care costs would be stable. Unfortunately business got bad
and the money paid for health care started to appear to be expensive. Business
got so bad not because of the health care contracts but to al large extent
because of the ineptness of the American business men who lost large chunks of
domestic and foreign markets to the Japanese and others. The article expresses
surprise that workers with health care contracts use them to take care of their
health. Unfortunately a person without health insurance too often neglects his
or her health, or devotes money to the care of the kids at personal sacrifice.
Is health care
and medical care costly. Of course.
It is a very personalized service. A
single individual going to the hospital for a medical illness is catered to
personally by highly trained specialists, nurses as well as dieticians and
therapists of all kinds. Many who formerly would have died now survive their
illnesses. Death is the least expensive outcome of an illness. The attempts to publicize the high cost of medical care and to reduce
them by cutting back on the availability of health care facilities has
an ominous ring. Medical costs can be cut to zero if medical care is no longer
rendered.
Of course in the
length and breadth of the article no one addressed the question as to why high
health costs are bad for the country. Certainly the salaries and costs are
moneys internally circulated. The health care industry is a large employer,
possibly the largest in the country and generates lots of tax dollars.
The minimum
wage is certainly a factor driving up health costs. There was a time when most
of the hospital maintenance and kitchen work was done in return for room and
board.
What else
drives up health costs? Five hundred thousand injuries a year suffered in
automobile accidents; ten million alcoholics in the country who are at risk of
chronically diseased livers, hearts and brains.; a well subsidized tobacco industry that
causes an un-measurable amount of heart disease and a measurable amount of lung
cancer.
And where else
does the money go? To finance expeditions in
I think what
peeves the government economists about the cost of medical
care is that the money spent doesn’t purchase a palpable product. And
the economists really don’t care how we feel; unless how we feel cuts back on
our productivity.
President
Reagan wishes us well but doesn’t want to pay for it. And we as individuals
inveigh against the cost of medical care until we as individuals get sick.
The New York
Times article intimates that most of the medical care rendered is unnecessary.
Maybe, but that fact doesn’t emerge until the illness is over.
No patient in
my experience has ever come to my off ice saying “Doc you gotta
save me money!” Tghe patient may ruminate
baout the cost of illness after it is over and done
with, but at the beginning the patient says “Doc, you gotta
help me”.