Centerfield

In other words, a much better name for the Bush grandchild tax is the "we keep voting to have our cake and eat it too" tax.

I'm shocked.

Higher costs are not the "inevitable" result of having the latest advances in medical technology. It certainly is not the case in most areas of technology. Computer capabilities continue to expand rapidly while prices remain constant or fall. Every year, I price my "dream" computer system. Every year, it gets better and better. And every year, the price is between $4,000 and $5,000. More computer, same price.

Our current system distorts the "market" (such as it is) for health care services so drastically, that there is very little creative and entrepreneurial thinking going on to deliver the services more cheaply. Why make something cheap when the people making the purchasing decisions (the patient and the doctor) are not the ones directly paying the bill?

Pat, those are several very good pointa, but only as far as they go. Certainly a given technology becomes lkess expensive as it matures and becomes mass produced. But in the case of health care, isn't the real problem simply that it's likely that every extra year of life expectancy is going to cost more than the previous year bought because it's harder to achieve. In other words, the goal line keeps moving. I'm sure many efficiencies could be wrought from the current system, but will such efficiencies diminish the demand for longer healthier lives in any way other than by making extra long lives unaffordable for all but the wealthiest?

I am still baffled why the Hillary Clinton/Newt Gingrich proposal to standardize billing forms and procedures is not making any headway. It seems to be the least controversial way to take a big bite out of Health Care costs.

This topic can be viewed on so many levels. The question I have is whether non-health care spending has decreased as a result of the increase in spending on health care. Obviously it has as a percentage of the economy when you combine non-health care and health care spending. But separating the two, what does non-health care spending look like over the last few years? In other words, should we care that much? Maybe so, but keeping yourself alive is a pretty fundamental thing to spend your money on. I know people will say that the cost of health care could be lower, and should be as low as possible. And I agree. But how much lower can the cost of health care be if you want the latest and greatest, right up to the inevitable end? There was a previous post a month or two back linked to an article proposing an icing and cake analogy to health care costs. It said, in short, that the administrative/bureaucracy-driven costs of health care are the icing, containing some small portion of the calories in the cake, whereas the fundamental costs of the care itself were the cake, containing the bulk of the calories. Reducing or even eliminating the icing still leaves you with most of the calories. After that, the only way to reduce calories is to reduce the cake itself, by providing an using less health care. Hmmm, reduce the cost of health care by reducing health care itself. That's one way to "solve" the "problem."

Health care costs may also be growing because of couch potato-syndrome. Fatter people exercising less means more diabetes, heart conditions, etc., etc. Not all the extra costs are in life support for old people.

Ethical considerations also play a significant role. Keeping people with no hope of recovery of consciousness alive on ventilators and so forth for months or years is very expensive. We don't like to think that survival for that last month or two depends on whether you can afford it or not, but at the same time we must ask whether other individuals have an obligation to pay for the care of you or your family simply because you cannot, or chose not to save for.

Funny you mention that, Pat. Here's something I just ran across that suggests some evolution of opinion on such matters:

Polls show growing support for the right to die

This is kinda like the folks in Indonesia a year ago: "Hmmm, I wonder what that is off in the distance?", "I bet we oughta do something about it? what do you think?", "We're probably safe up here"....

I don't think the issue is so much how much society spends in toto on health care, as it is how it is spent. People are legitimately concerned that we have a two-tier health care system--that more affluent people receive better health care. In some ways, it's better to be poor than to be middle class--there is medicaid for the poor, but the middle classes are increasingly getting squeezed.

The problem is, people don't want to accept that there is going to have to be some rationing of health care, either through the price mechanism or something else. There is just no way that you can avoid setting some sort of limits.

I don't think the market is the solution for everything. I think health care is really a public good--using a pure market system is not likely to work. On the other hand, I'm uneasy with the Canadian solution, which seems to be having its own problems.

What I do think, however, is that, simply from an economic point of view, we are going to have to find some new way to finance health care. We just can't expect business to pay for it--we see how health care is killing GM.