Medical Costs

The New Yorker has a story on medical costs this week:

The Cost Conundrum by Atul Gawande

where I found this:

“The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

My favorite villain for our economic debacle is the Military-Industrial Complex and their billion dollar high-tech creations, but what do I know? Maybe we are all going to be working at the hospital, eating hospital food, wearing hospital uniforms.

But Senor Gawande explores the issue at some length. It's a well written story, and I would never have suspected that it was written by someone with the name of Atul Gawande. I've been attending some seminars at Portland State recently and half the people there have names I cannot pronounce and accents that are difficult to decipher. Funny how that works.

Anyway, the main point seems to be that some doctors are more concerned with making money than providing good health care, and it seems to be a community based thing: doctors influence other doctors. Why some communities go for the bucks and some for good care is something of a mystery, but having peer groups that meet regularly to share information seems to push the group more to the quality of care side of the balance.

So then I had a big idea, and I wrote a letter to the editor:

Strikes me that there is an opportunity for an insurance company here: work with physicians groups to contain costs and improve care, ala the Mayo Clinic and Grand Junction models. This would enable them to beat their competitors over the head in the advertising arena on both issues. Secondly, if they could successfully contain costs, then they would be able to charge less for their insurance and then possibly attract more customers. It would be a long row to hoe.

On the other hand, even if we can contain costs, and improve the quality of care, is it going to be enough? That is, can we afford to treat everyone in country? I am not sure, but I think our medical costs for our family of five have been between 10 and 20,000 dollars a year recently, including what the insurance company pays on our behalf, and we haven't had any serious problems. I have three teenagers who all went through braces, and that was a chunk of change, but other than that it is just run of the mill stuff.

Cheers.