Government officials warned Congress the other day that health costs are rising so fast that they threaten the long-term economic stability of the United States. Yet neither those officials nor Congress have any answers. They are like witnesses to an about-to-happen crash, but seem paralyzed by the sight.
Doctor, hospital, and medical insurance costs are soaring far faster than inflation or growth in family income. The increase in the past five years alone has been 54 percent. Last year, Americans paid $647 billion in medical costs, nearly $2,600 for every man, woman and child in the country, or about 20 cents out of each dollar in per capita income.What is the nation getting for this vast expenditure? Only one in 10 Americans think the health care system works well. An estimated 33 million to 37 million people - most of whom work and are not poor - have no medical insurance coverage. Costs in some medical emergencies can quickly total more than a lifetime's earnings for an ordinary wage earner.
As bad as that is, it will get worse. According to Richard Darman, director of the White House Office of Management and Budget, health care now accounts for 12 percent of the nation's $5 trillion annual output of goods and services. By the year 2030, it is expected to consume 37 percent of the gross national product and more than a third of the federal budget.
By the turn of the century, less than a decade, health spending will overtake Social Security as the biggest item in the federal budget, if present trends continue.
What's to be done? Suggestions range from some form of nationalized medicine to drastic cuts in entitlement programs like Medicare, to caps on spending, to raising the retirement age, to helping only the poor. But all the experts see fatal flaws in all of these suggestions, both economically and politically.
One possibility is to reduce the malpractice threat to doctors. This threat leads to the widespread, unnecessary use of lab tests and other medical procedures which raise costs. Medicare has become a huge drain on funds and perhaps should be used only for elderly people below certain income levels instead of applying to everyone over 65.
Government and insurance companies simply must become more strict about setting limits on what they will pay for certain medical procedures.
And doctors must get away from the view held by some that because of their expertise and long years of training, they are "entitled to" or "owed" a certain level of income. That shows up in some physicians refusing to take Medicare patients because of the payment limit on services rendered. Reducing the threat of malpractice also would take some pressure off the need to charge high prices.
Some fundamental solutions will have to be found quickly or Americans could end up working most of their lives just to support the nation's medical-care system and pay the interest on the national debt.