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The Blessing of Rising Healthcare Costs

The skyrocketing cost of healthcare in the U.S. has been a major source of concern for some time now. Recently, President Obama declared that the exploding cost of health care in America today is "one of the greatest threats not just to the well-being of our families and the prosperity of our businesses, but to the very foundation of our economy.... The greatest threat to America's fiscal health is not Social Security, though that is a significant challenge; and it is not the investments we've made to rescue our economy; it is the skyrocketing cost of health care."

And indeed, the statistics corroborate the President's concerns. In 2007, the cost of healthcare in the U.S. was an astounding 15.2% of the nation's GDP, second largest of any nation. Or, in more comprehensible terms, in 2007, healthcare cost per capita was $7,421. Compare that with $148 per capita in 1960 (source: Centers for Medicare & Medicaid Services). One need not be an expert to understand that that is well above the rate of inflation.

Would that we went back to those simple times, when a family health insurance plan wasn't in itself a major cause of health problems such as high blood pressure and anxiety...

So how do we reduce healthcare costs? It would seem reasonable to start with identifying the reasons behind the soaring costs. Then, hopefully, we can start cutting them—and passing the savings on to the consumers.

Poking around on the internet, I've learned that there are five key causes for the exponential rise in healthcare costs:

1) Student Loans. Doctor's fees are somewhat inflated because many of them are saddled with substantial student loans. The 10-12 years of pre-med and medical school that provide our physicians with the best education, skills and hands-on apprenticeship are costly—and that cost is eventually passed on to the doctor's patients.

2) Longer Life Expectancy. During the 20th century, life expectancy in the United States rose more than 30 years. Old age, though certainly a blessing, brings a variety of unique health issues that often require costly treatments.

3) Malpractice. Doctors and hospitals pay steep premiums to cover their malpractice policies. In times past, medical institutions and practitioners were not held to the highest level of responsibility; mistakes were usually left unpunished. In addition, for fear of lawsuits, doctors are extremely cautious—prescribing batteries of expensive tests and diagnostics based on even slight suspicions, resulting in many conditions diagnosed in their earliest stages and then successfully treated.

4) Medical Equipment. The high-tech machines and diagnostic equipment used today are extremely expensive.

5) Research and Development. The medical establishment no longer relies on "cost effective" treatments such as ground herbs, brandy, leeches and cold compresses to cure diseases. Today's medications are very expensive. In the United States, the development of a single drug can cost between $10-$200 million—and approximately one in ten of these drugs reach the market. This all due to the numerous protections installed to ensure that the drugs are safe and effective.

So now that we've identified the major culprits causing this crisis, where do we start slashing expenses?

Do we cut a few years out of medical school? Do we stop treating conditions brought on by old age? Maybe we should stop holding doctors accountable for preventable errors? Or do we maybe call for a moratorium on the production of medical equipment and drugs—or simply relax our standards on what we allow on to the market?

I hear that in Zimbabwe medical care is still relatively inexpensive. Maybe we should follow their lead? (Does it really matter that life expectancy there is 39.5 years?)

(I'm also aware that this crisis is partially caused by fraud, waste, and exorbitant tort verdicts. While these areas should certainly be seriously addressed, doing so will not eliminate the high costs caused by the factors enumerated above.)

I believe that it's time for a shift in perspective. Oftentimes, that which is perceived as a curse is in actuality a blessing (not even in disguise). High healthcare costs are a direct result of the fact that we have the absolute best healthcare that ever existed in the history of this world. As we get nearer and nearer to the coming of the Messianic Era, when all disease will finally go the way of polio, we are making hitherto unimaginable leaps and bounds in that direction. This is a cause for celebration, a reason to daily express our gratitude to G‑d.

This doesn't mean that we can rest on our laurels and simply count our manifold blessings—unfortunately there are many who can't afford these blessings available today. And I certainly believe that it is the responsibility of the government and communities to ensure that all, even the least fortunate, can avail themselves of the highest quality medical care. But instead of grumbling about the costs, let's embrace them; they are, I certainly hope, not going away. And then, as the wealthiest nation in the world, we must respond to the challenge of making these costs manageable for everyone.


On a more general level, this lesson is applicable in so many areas of our life. Quality control is raising prices in all areas of the economy. Take construction, for example: today everything has to be fireproof, handicapped accessible, construction materials must be of top-grade quality, etc. So we pay more for a house or to build a bridge, but can we put a price on the peace of mind that comes with knowing that the electrical wiring in the house was done properly, and is highly unlikely to explode at any given moment?

We pay for what we get.

This is also something to consider next time we feel that Judaism is "costing" us, when it seems that the effort and discipline (and sometimes also the practical costs) it calls for is over the top.

Instead of seeing these things as costs, let's embrace them for what they really are... Let's not move to the Zimbabwe of the soul.


24 Comments Posted  |  Post A Comment
Reader Comments
Latest Comments:
Posted: Jan 29, 2012
Right Focus?
Yes, we do have an aging population, but so do other developed countries where the people are healthier and pay less than us. The elderly have medicare (for which the younger generation pays) that covers their most basic needs, such as doctor's visits, so I don't think we should focus on that.

The drug companies focus on marketing with their Research and Development teams (Did you know that amphetamines used to be sold as weight loss pills and now they are marketed for ADHD?). There was a Times article 1-2 years ago that explained how many of the 'new' drugs have just a slightly different formula than the old one, but with the new patent can keep the inflated price tag. One can buy the generic medication from overseas up to 50 times cheaper...

If we have become better at detecting malpractice the hospitals and the staff have become more efficient at preventing it. What I find ridiculous is that the hospital will charge you $1000 just for staying there...
Posted By Anonymous, Huntington Stati, New York

Posted: Feb 24, 2011
The Myth of "The Myth of National Healthcare"
Markson Cadus criticizes NHS in contrast to the U.S. where as soon as the doctor wants you scanned "the Dr tells you to hop on to the bench and out comes the Scanner" and then the doctor gets paid for the scan.

That is precisely the problem with the U.S. system and the advantage to NHS.

In the U.S., patients receive grossly excessive amounts of treatment and scanning, and it does not help their health. The most influential factor in how much care or treatment a patient receives is the number of providers available where the patient lives. In South Florida, Medicare patients receive more health care than anywhere else in the U.S., and yet the overall death rate for Medicare patients in South Florida is just as high as in the other 49 states. Why? Simple. Medicare patients in all 50 states receive enough health care, and then some. The extra received in Florida provides no further benefit to the patient, and occurs only because the providers need it, for financial reasons.
Posted By Anonymous, Camarillo, CA

Posted: May 19, 2009
The Myth of National Healthcare
I am an American living in the UK, which is famous for the National Healthcare System (NHS).

It is a disaster. My family are going through hell just through a pregnancy. In the states, you choose your OB., see the OB on every visit and they deliver the baby. Any complications they work with you.

With NHS, you see one of a hundred midwives, who know nothing of your condition, you have to carry a book with you where all your records are written down (lose it and you gotta start from the beginning). No one sees your whole picture to put two and two together or notices a problem that needs fixing. Also, once you have determined that you need a scan etc. you wait 2-3 WEEKS (!) where in the states the Dr tells you to hop on to the bench and out comes the Scanner.

Cancer patients are told that they wont get certain treatments because they're too expensive. People die on waiting lists....

There are major problems with US health care, but don't replace it with a worse 1 just b/c its dif
Posted By Markson Cadus, London, UK

Posted: Apr 22, 2009
In other words, problems abound. Many of the systems in place lock people out of access, even when the facility is local, US or not. Do you find satisfaction with the current fee for service structure? While enjoying the advantages of being where a lot of the research is, we are also paying more for those procedures, even when they become routine. But why is that right? Shouldn't people in other countries share that cost?

And what is right about a hospital in India, Costa Rica, Singapore, (you get the point) serving North Americans and Europeans rich enough to travel, but not the guy who lives two blocks away?

Jered, you said people NEVER go outside the US for treatment. Why had you never heard of medical tourism? Now you find stats to say who they are. Now you have learned, the day wasn't wasted.

You write the way someone who has always had ins. coverage in the US would write. Try pricing your proceures without ins. co. discounts. You will be traumatized.
Posted By Sarah, MI/USA

Posted: Apr 22, 2009
Jered
Given that these Stats are from a reasonably competent source, we can assume they corrected for the variables in the original reports of the data. (They probably asked about specific birth weight babies, and did not let the docs define live birth, etc.)

As stated, in that the samples are so large, they are also most likely statistically reliable. Also, lifestyle can be considered part of health care, if it is part of policy. (Did you know that in Japan the dangers of smoking are far less emphasized than in the US? Think of the ramifications.)

Third, you haven't given any numbers to support your statements. All you have done is demand I defend mine,which I have done. This is my second request. Either document or quit.

Lastly, you are the only one in this conversation who claimed to have never heard of medical tourism. Why didn't you?

Cynthia, anecdotes tell us where to look. That the term medical tourism exists is a sign. That Jered didn't know the term is also a sign.
Posted By Sarah, MI/USA

Posted: Apr 22, 2009
to Sarah and others who yearn for socialism
It is CRUCIAL to take note that countries with drug price controls may be able to provide drugs to their people at lower cost, but they are not investing in research and development and are not producing new drugs. The U.S. produces approximately 90 percent of new medicines.

We should be both grateful and proud to belong to this innovative country that brings so much benefit to the rest of the world.

Sarah, what does this mean? “With such large samples (full country) the other factors are most likely proportionally expressed in all groups. (My old Stats Prof. would be horrified to hear me state it this way.)”

You say: “These stories are becoming frequent enough that they are becoming "statistically significant".” – Your old Stats prof would be horrified if he heard you say that your own personal anecdotes can ever become statistically significant.

Wishing best of health to all of us!
Posted By Cynthia Jordon, AL

Posted: Apr 22, 2009
To Sarah III
Re medical tourism continued:

The people who are traveling for BETTER health care are more likely from countries where the health care is socialized and so the lines are too long. From the World Health Tourism Congress: "The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in New Zealand, Costa Rica, Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival. In Canada, the number of procedures in 2005 for which people were waiting was 782,936."
Posted By Jared Greenstein, IL

Posted: Apr 22, 2009
To Sarah II
3) Here are some numbers. In 1999, in a report titled “The Elderly’s Experiences with Health Care in Five Nations,” the Commonwealth Fund found that only 4 percent of American seniors reported long waits for serious surgery. In Canada and Britain, with socialized health care, the rate was 11 percent and 13 percent, respectively. For non-serious surgery, the differences were even more dramatic: 7 percent in the United States compared to 40 percent in Canada and 51 percent in Britain.

4) Regarding medical tourism. Yes, sometimes Americans travel for medical procedures that are cheaper elsewhere. (A common “out-sourced” procedure is elective plastic surgery.) Medical professionals in other countries are often willing work for less, and they are also not subject to the same regulations. (If something goes wrong, can the medical tourist sue?) This does not say anything about the quality of the results here or there.
Posted By Jared Greenstein, IL

Posted: Apr 22, 2009
To Sarah I
1) Many things contribute to shorter life expectancy statistics that have nothing to do with medical care, like rates of fatal car accidents, injuries, and homicides, typical life-style (diet and exercise), and proportions of race and social class.

2) Different countries define infant mortality differently. According to Jim Perom, of the Foundation for Economic Education, "any infant, regardless of size or weight or premature status, who shows sign of life is counted as a live birth in the United States. Germany, which ranks number one in the Commonwealth Fund survey, doesn’t count as a live birth any infant with a birth weight under 500 grams (one pound)." These statistics are not meaningful.
Posted By Jared Greenstein, IL

Posted: Apr 22, 2009
US health care versus Canada
I'm reading with interest the many posts here. For someone who lives in the province of Ontario in Canada, with our government paid health care system (OHIP), the costs of health care in the States are certainly overwhelming.
On the other hand, I can testify that a few years back when my father had a growth in his kidney and we needed to act urgently, we took him to Cleveland for his operation and paid for it out of pocket. It was well worth paying for, since he got the most up-to-date treatment, quickly and efficiently and thank G-d recovered. Doctors here in Ontario admitted openly that the new methods and efficiency of the superb Cleveland clinic could not be found here. I know of many other individuals who also travel to Buffalo or other nearby cities in the States to get immediate treatment, instead of waiting for months,often with irreparable damage to their medical condition.
I guess both systems have their advantages--and maybe both can learn from each other how to improve!
Posted By anne


 



By Naftali Silberberg   More by this authors...  |   RSS Listing of Newest Articles by this Author
Rabbi Naftali Silberberg resides in Brooklyn, NY, with his wife Chaya Mushka and their three children.

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