Sirensong

I think it's quite interesting that the only top-earning profession that's truly necessary is probably the only top-earning profession that's getting salary caps.

mrxalleycat

Good points

my$0.02

NYT opinion.
http://www.nytimes.com/2009/11/15/op...=1&ref=opinion

RSBuletz

"the high prices charged for medical services in this country and the volume of unnecessary care delivered by doctors and hospitals, which often perform a lot more tests and treatments than a patient really needs."

Wouldn't malpractice reform ease the price pressure on some of this?

Son of Opie

If we start talking about health care as a right, then we need people to start thinking of maintaining their own health as a responsibility...

afan

This one is the same misleading thought as "better preventative care will reduce illness and save money". The problem is that the mortality rate for being human is 100%.

Consider two 50 year old guys. One is fanatical about health, avoids all unhealthy practices, moves to a place of blue skies and pure water, gets the proper amount of exercise and eats a macrobiotic vegan diet. The other takes a cigarette out of his mouth just long enough to cram in another cheeseburger. And lighting up is his idea of a workout. The first guy will be healthier, and on average he will live longer. But 60 years from now both will be dead. Before they die both will have a good chance of using up health care dollars. Patient A's lifestyle will reduce his risk of diabetes, but he can still get heart disease, cancer, or suffer trauma.

No matter how careful people may be about their health, they will still get sick and die. All of them. So lifestyle will simply shift the mix of diseases from those largely determined by life choices (type II diabeters) to those that one cannot avoid.

The evidence says that preventative care does not save money, and healthy living simply postpones expenses, but does not eliminate them.

Shrinkrap

I'd like to see that evidence about healthy living. Are you saying for example, that the total expenditures on health care would not change if there where no smoking and no obesity? Does it address expected increases in productivity?Doesn't dying of heart failure for example, cost less then dying from the complications of poorly managed diabetes?

bluedevilmike

I don't have the studies on hand, but I think afan is more or less correct. The changes are pretty small. I know that once folks hit ~age 60 their lifetime medical expenses are almost entirely the same no matter what their incoming health is. I think unhealthy people are more expensive at younger ages, though.

If memory serves, the studies in question are unequivocal that preventive care is not a cost-saver; the savings from healthier living are vastly offset by the expenses of that preventive care. (This is largely because preventive care on lifestyle issues is so hideously ineffective.)

Those studies do not address background economic factors like productivity. Then again, neither does health reform.

afan

Not at all clear what effect the improved health would have on productivity, or who would benefit. This requires lots of assumptions about the actual productivity of the people under discussion, whether they are in the work force at all, if they do work whether they are doing something useful, or even legal.

The argument for extending health care to all, and improving the health of everyone is a moral one. Not at all clear you save money.

But the overwhelming point is that, no matter how healthy your lifestyle, you will end up as dead as everyone else. So put the responsibility entirely on the individual, and they MIGHT pay more attention to their health, I do not know of any evidence on that subject, but it may be out there. However, do not assume that forcing people to assume this responsibilit will reduce health care costs.

Shrinkrap

I've seen the stuff on preventive care, but I'm not sure what "preventive care on lifestyle issues" means. I don't doubt that there is no cost savings. I'm thinking largely of health risks associated with obesity and tobacco. Nothing comes to mind with regard to "preventive care" as it relates to obesity and tobacco. Anyway, that's taking this off topic.

bluedevilmike

E.g. anything that the medical community can do to prevent drugs use or obesity. We might get some savings from those folks who stop doing drugs or who lose weight, but the number of interventions you have to do to stop just one person means that there are no cost savings.

That's not to say that preventive care isn't a good idea. Just that we can't expect to SAVE money by doing it.

.enigma.

Btw, something else to think about. Imagine how much tax revenue the government would lose if a large majority of the American population stopped drinking and smoking.