Lucille Bluth: I'll be in the hospital bar.
Michael Bluth: Uhh, you know, there isn't a hospital bar, mother.
Lucille Bluth: Well, this is why people hate hospitals.
- Arrested Development
A tenant of the conservative approach to health care is that the insured tend to overuse medical services, driving up medical costs. Always struck me as a talking point that really doesn't hold up under the examination of common experience. Who are these people that love doctor and hospital visits? Via Ian Welsh at The Agonist, Wageworks has a study that has this interesting finding.
The survey found that more and more insured Americans are behaving just like the uninsured and simply ignoring their health needs as a way of coping with rising health care costs.
So the insured are not getting that free ride that has them scheduling doctor appointments at a rapid pace. A shame that people are not getting the joy of reading 3 year old magazines in waiting rooms while trying to guess the disease that the coughing, rash-ridden patient in the corner is suffering from. The study goes on to trash this conservative talking point all to hell.
More than half of those surveyed who had employer-sponsored health insurance said they had delayed a medical or dental visit in the past year.
Furthermore, more than a firth reported having cut back on prescription medicine.
The implications of this for workplace productivity and the wider economy could be significant – as it is self-evident that workers who do not feel 100 per cent for whatever reason will not work as effectively as those who are fully fit.
Mr. Welsh cites the study in making a strong case for single payer.
Of course, 40% think health care costs should be kept low through individual action. Which is a nice, responsible thing to say, but not very realistic. Americans don't get more surgery than another nation in the world because they need it, as far as I can determine, for example, they get it because surgery pays very well for the doctors whose job is to reccomend treatment and non-surgical alternatives are often either not offered, or if offered they are downplayed.
Health care costs are a major drag on the US economy. As of 2005 health care spending in the US made up 16% of GDP, and for this you get 43 million uninsured people, huge amounts of underinsured people (perhaps around 50% if one uses the study above's numbers), and massive numbers of bankruptcies caused by health care costs (about 50% of all personal bankruptcies in the US). And because US companies have to provide health care, they aren't competitive with foreign companies which don't have to. (Don't believe me on this, GM and Ford think so too, which is why they sent Canada's government a letter asking Canada to keep its universal healthcare system.)
The stone dead simple thing to do is to go to single payor. The evidence out there is that single payor is about 1/3 cheaper than the current hodgepodge the US has, and in the Canadian experience, those savings were achieved in less than 10 years. 5% of GDP is a lot of money - about $2,200 a person, or about 670 billion dollars (as of 2005, it'd be more now).
That $670 billion, by the way, is what you pay so a lot of people can either make a living, or in many cases get rich, off your suffering. And that 670 billion is why it's so hard to change things - that's a lot of money; it's currently flowing through people's hands, and they don't want it to stop. And $670 billion buys a lot of clout.
One of the things that has always bothered me about the overuse argument is that it seems to fly in the face of the belief in the cancer treatment community that early detection is one of the best ways to increase cancer survivability rates. Postponing physicals and thinking that a possible symptom will just go away seems seems to a major part of the problem.