This article was originally published on The Well-Read Man, on June 20, 2017.
Part 1: Introduction
Healthcare is perhaps the most visible domestic policy concern for Americans here in 2017. Whether it is the president and Congress arguing over the fate of Obamacare or the constant stream of TV commercials for old-people drugs, our daily experience includes an endless concern over medical care.
Part of this has to do with the increasing costs associated with health insurance and provider care. Not that most people pay the full costs themselves. In 2015, for example, 84% of Americans had at least part, and often most, of their healthcare premiums covered by an employer or government program. But those premium payments do not manifest out of thin air. The money to pay them has to come from somewhere, leading to lower base incomes for employees with health policies, or higher taxes that cover government-sponsored or reimbursed plans.
Beyond the subsidization of insurance premiums, there are also significant out-of-pocket costs. Thanks to inflation, prices for most things are constantly on the rise, but healthcare regularly outpaces the basic inflation rate (see table 1).
|Year||Inflation Rate||Healthcare Increase|
Source for Healthcare Increases: “National Health Expenditures Summary Including Share of GDP, CY 1960-2015,” Centers for Medicare and Medicaid Services. Source for Inflation: BLS Inflation Rate.
These higher healthcare costs do not even take into account increased premiums paid by individuals or families who must fund their own policies, or the higher deductibles that nearly everyone is seeing. Healthcare costs seem to be skyrocketing, well beyond other sectors of the economy. The question, of course, is why.
The general perception is that greedy insurance companies, drug companies, and doctors are driving the increases. One can always find examples of corporations behaving badly with profits or regulations, but anecdotes are not the same as institutional trends. If medical insurance is such a lucrative business with record profits just a greedy boardroom decision away, why are so many insurers exiting local markets? There is also the question of why those working in medical industries would be any more inclined to greediness then, say, those who run grocery stores.
A friend recently told me that healthcare is too important to leave in the hands of ordinary businesses. If we look at the industry as a place where the ill and infirm are drained of their life savings for pure ego and profit, then it is understandable that someone would balk at for-profit companies doling out healthcare for money. And yet, most of us have a heartfelt respect for doctors, and we depend on hospitals to support us in a crisis. How can we praise providers one minute, and condemn them as thieves and charlatans the next? What is the big deal with the medical profession, and why are we pumping all our money into it?
We will look at these questions and more in upcoming articles. And we will try to do it all without resorting to hysteria and anger, feelings that, like healthcare costs, appear to be on the rise across the nation. If you have been confused by the battle over the cost of healthcare, or even a little angered, then let us take some time together to thoughtfully find out why this industry is consuming all of our thoughts and bank accounts.
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