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.