Dollars and Sense: The US Healthcare Debate

Okay, it's time for another blog. This week, we read an article outlining the impact of the recession on health economics. As we've learned in the course, health spending in the US makes up an enormous percentage of GDP. According to this article, that number will only continue to increase. An interesting point made in the article was that although overall spending may be decreasing, health care spending most likely will slow, but not decrease. Health care spending is usually effected by recessions over the long term (i.e. people will save less and thus spend less on health care in the next few years). Another interesting point is that as a result of the recession, more people are shifting from out-of-pocket payment plans to Medicaid. The government needs to plan to accomodate this extra cost.

This increase in health spending in the public sector has serious consequences. If health care spending continues to occupy more and more of the GDP, the nation is in essence spending all of its money on a service good, something that is not exportable or particularly profitable. And, as the proportion of the health spending that is done by the public sector increases, the US government (already in serious debt) continues to spend more and more money it does not have on an inefficient system. If the government is going to spend so much on health care, it makes sense to shift to a single payer system. At least that would eliminate the enormous administrative costs associated with the current system. As the government continues to shoulder more of the cost burden of the health care system, it seems they should be given the opportunity to have some administrative power in a system that is costing them so much.

Within the health care debate, there are many key issues. In many ways, the debate is rooted in the US value system. Our society values instant gratification and people feel they deserve immediate access to the best and newest technologies. The decision to shift to a government-run system would require an ideological shift. Another key issue is centered around reimbursement rates for physicians. In this country many medical students incur large debts to obtain a degree. It is important that these professionals are compensated appropriately for their efforts and advanced knowledge.

Although there are many more issues involved in the health care debate, if I had the ability to change one thing, it would be eliminating the uninsured portion of the American population. Sixteen percent of Americans are uninsured (more than 46 million people). This is not only a social injustice (in my opinion health care should be a human right) but it also has serious economic consequences. These people are highly unlikely to access primary care and thus receive little preventative care. Therefore, when they become ill, it is usually fairly serious, and many times could have been completely avoided. Then, when they finally seek help, it is usually in an emergency room. Visits to the emergency room cost the system many times more than visits to general practitioners. Finally, since these people often cannot pay the costs incurred during their visit, these costs are shifted to insured patients. It is through this system that the health care system accrues enormous extra costs.

That's all for this week. I will be back with more intro to public health blogs after Spring Break.