why health care costs can never fall as a % of GDP, Part One
October 7th, 2009 by Al Lewis (alewis)This is the first in a series of blogs over the next week to explain why we need to get used to health care expenses continuing to rise, unless we are willing to discuss the R word (rationing).
If all doctors and hospitals did was the same procedures we did 30 years ago, spending would be way down. Total hip replacements, for example, were 16-day stays in the early 1980s. Now they are often four days or fewer. In the 1960s cataracts were a 3-week inpatient stay requiring sandbagging (does anyone even remember sandbagging?), surgery done only as a last resort.
However, each advance in those procedures (and every other procedure) generates demand for two reasons.
First, many more people will want something, much sooner in their disease progression, if it is an easy procedure. So 4x as many joints are replaced as 27 years ago, while cataract surgeries have increased 20-fold since the 1960s.
Second, there is no economic check-and-balance against this because these procedures are virtually free
TO BE CONTINUED
Tags: health care reform, healthcare costs, healthcare policy, healthcare spending
December 13th, 2009 at 5:06 pm
Rationing is the magic word. Your write - up in Oobonomics about the use of the hospice-style “end of life” specialists instead of the “extension of life” specialists would be a good place to start. There is a special person specifically trained and designated for a similar type of PR work on organ harvest teams. They know all the right things to say to convince a family that the best thing to do in their tragic situation is to help someone else by the donation of the organs of their brain dead relative - and they get all the appropriate papers signed in a time-expedient fashion.
I googled Medicare DRG 541 after reading about it in Oobonomics and have it on my agenda to show your write-up to a hospital comptroller for his take on it.
Certainly it would help if the profit motive were somehow minimized.
DB