Why is the cost of healthcare so high?
In the debate on healthcare that took place during the first Clinton administration, Mrs. Clinton had a straightforward explanation for the uncontrolled growth in healthcare spending. To paraphrase loosely: There are too many greedy doctors using too much expensive technology.
The problem in trying to refute this synthesis, at least for those of us physicians who do not like being characterized as avaricious and for the biomedical engineers who do not like their remarkable inventions being characterized primarily as expensive, is that there is a lot of truth to it.
However, most long term care insurance economists agree that there are at least four factors driving up the cost of healthcare. These are:
♦ Waste
♦ Fraud
♦ Increasingly expensive medical technology
♦ A rapidly aging population
The first three correspond to the Clintons’ explanation of the problem. The difficulty with their explanation (aside from its being insulting to some of us) is that it downplays the most pressing cause for the rising cost of healthcare. And with good reason. It is easy, even advisable, to criticize doctors for being wasteful, greedy, and felonious. It’s even okay to criticize technology as long as you don’t get too specific about it. But it’s not nice, or politically wise, to criticize people for getting older.
