By Paolo von Schirach
June 30, 2012
WASHINGTON – I was watching one of many TV talk show discussions on the US Supreme Court decision that declared the Affordable Care Act (Obamacare) constitutional. (Link to related story above). While the issue was of course about the future of the measures included in the legislation, now that there are now doubts about their legality, at some point a leading health care expert commented that the real issue about US health care is the staggering cost, 1/3 of which is due to waste. At 18% of GDP the price tag of American medical care is at least 30% higher that the average of what other rich countries spend.
1/3 of US health care cost due to waste
The expert, editor of a respected non partisan and non political journal, stated that much of this cost is due to wasted money. She said that about 1/3 of the total bill is due to procedures and prescriptions ordered by health care professionals that are in fact useless. Now, coming from a recognized expert, this is really important. Think about it. While the Obama legislation addressed mostly the extension of health insurance coverage, so that many more millions would enter the system, the real issue is runaway cost, increasing year after year at a rate that far exceeds inflation.
And now we are told that much of this cost is due to useless procedures. Money out the window. Indeed, we have an expert saying on national TV that, by the way, at least 1/3 of what we spend is wasted on stuff that serves no real medical purpose. Now, that’s about 6% of US GDP. This is more than the entire US defense budget; hardly a detail or rounding error.
This should change the focus of the debate
Well, you would have thought that such a powerful indictment indicating that there is something profoundly rotten in a system that allows (or promotes?) this level of waste would have invited some more scrutiny in a conversation devoted to health care. Quite clearly, if we could stop this waste, we would deal with a much smaller volume of activity and a smaller bill. This would greatly reduce the size of the problem.
But no, the TV talk show hostess did not even blink. Amazingly, the bomb shell-like observation made by the revered expert did not even register. After all, her remark was off the subject. The show’s topic was about the consequences of the now established constitutionality of Obamacare, not about reducing health care costs.
We keep talking about the wrong issue
Never mind that taking notice of this staggering level of waste in overall spending should have reshaped the conversation entirely. This did not even cross the hostess’ mind. And so, even though reputable experts tell us that the real US health care problem is absurdly inflated costs, we keep debating how to pay for them as if they were all legitimate. Wrong focus, wrong debate, useless outcomes.