SAY ANYTHING . . .

Yesterday I asked the question of why health care costs so much. For the record, the question was occasioned by a bill for my wife’s six-hour hospitalization for pre-term labor–$1800.

Today in the Washington Post (thanks, OTB), there’s a bi-partisan effort (Sens. Bill Frist and Hillary Clinton) to spread the blame without providing any real answers to the problem of Malthusian health costs. I’ll give Frist and Clinton credit for pointing out that, essentially, we’ve got an outdated system based on diagnosing emergent health problems rather than preventing such problems in the first place. I only wish they’d come up with a solution, rather than just reiterating what we all know to be true already. (It’s also telling that there’s not a word about tort reform in this article.)

A huge part of the problem is that we’re, for the most part, lousy health-care consumers. We expect far too much of doctors, and educate ourselves far too little about the workings of our bodies. The classic example of this is the patient who demands antibiotics for a cold, which is a viral infection for which antibiotics are about as effective as eye of newt and tongue of salamander.

But we’d also rather take a pill than change our lifestyles, even though we know little about the long-term effects of the medicines we take. I love cheeseburgers, but I’d rather stick to my plan of one really good burger a month (and hold the fries, please) than take a medicine that might destroy my liver, but will keep my cholesterol down. In other words, I’d rather learn the proper way to incorporate cheeseburgers into my diet than depend on pharmaceutical companies to protect me from the effects of eating them too often.

We all know that “an ounce of prevention is worth a pound of cure.” So why don’t we have incentives built into our system to encourage people to lead healthier lives?

Simple: there’ s no money in it.

Think about it. If everybody led a healthier life, we would get sick less often–just for the sake of illustration, let’s say 20% less often. That would mean 20% fewer doctor visits, 20% fewer prescriptions, 20% fewer hospital stays, 20% less demand for home health care, 20% less exposure to malpractice suits, etc., etc. Only two elements of the health-care system stand to gain if everybody gets healthier: consumers and insurance companies. But everybody hates insurance companies, and we don’t want them to become more profitable, even though sooner or later competition would force them to lower their premiums if health care didn’t cost so much. The only people who come out ahead are consumers, and they come out ahead at everybody else’s expense. Therefore, it’s highly unlikely that the market will ever adequately reward Americans actually becoming healthier.

The only hope is to reach a “tipping point” wherein the amount of money that could be saved through lower health-care costs is greater than the revenues lost to the rest of the system. And if we’d reached that point, we’d know it. After all, hospitals and pharmaceutical companies also provide health coverage to their workers.