Too Much Healthcare

As I near 77, I find myself on a treadmill, you might say, of visits to doctors, specialists, clinics,  hospitals. Ditto for many contemporaries I hang with. I worry that our society can’t afford all the  health care that we oldsters enjoy. 

In just the past few years, I have had procedures or operations for Lasik, cataracts, hernia repair,  depression, prostate cancer, arrythmia, and more, plus many medications and endless check-ups.  

I have no idea what all that costs, because we are shielded from the numbers. I did read that the new-fangled proton beam radiation treatments for my prostate cancer cost $100,000, several  times the cost of traditional radiation for prostate cancer. But Medicare covered the treatments, and I was told there wouldn’t likely be any important side effects (there were), so who cares? 

As a result, I am in relatively good health, and thankful. Yet still I worry that we are robbing  Peter to pay Paul for all this. 

Some background. The U.S. Department of Health and Human Services reports that 5 percent of  the population consumes half the costs of health care. This nickel slice isn’t all for oldsters, but  much of it is.  

One of five dollars in our economy goes to health care. Health care costs have been rising faster  than economic growth since about the end of World War II. PWC (the former Price, Waterhouse,  Coopers) is a national accounting firm that follows this industry. PWC notes that health care  costs are expected to grow 6 percent next year (which is lower than the 9-12 percent annual growth of recent years), while the economy putters along at 2 percent growth or so each year.  Unsustainable. 

Don’t expect this growth to slow. Evermore exotic pharmaceuticals, technologies and therapies  tumble out of research labs, accommodated in ever-expanding hospital complexes, generally the  biggest employers in town.  

What careers do you encourage your children and grandchildren to pursue? Health care is near the top of the list, I’ll guess, because it’s a growth industry, pay is good and security seems  assured. 

At the same time, we are spending less on children, higher education and infrastructure, all  critical to our future, while the Chinese pour massive dollars into all these fields.  

From 1978 to 2014 (the last year Illinois had a real budget), spending by our state for higher  education, in inflation-adjusted 2014 dollars, declined from $283 per capita to $189. In contrast,  that for Medicaid (health care for the low-income, disabled and those in nursing homes)  quadrupled, to almost $1,300 per capita! 

Spending for our state children’s agency is also down, and Illinois hasn’t had a real infrastructure  program for our highways since 2010. 

I am at present paging through a college textbook about evolutionary science. [(Don’t ask me  why. Maybe penance for cutting my bio course so often in college decades ago. And it keeps me  out of the saloons, most days.)] 

The authors suggest that the amount of “energy” (the total inherent resources by which to  generate work or heat) available to a species is finite. And we are, after all, just another species  on this planet. 

To maximize the well-being of a species, we must somehow allocate that energy strategically,  that is, not waste too much of it on members that are no longer (re)productive. Ouch! That means  me. 

I am not, of course, proposing that we cut off all health care to oldsters. Those in our “golden  years” deserve to reap some benefits from all we contributed earlier. 

And yet we cannot steal from the most productive elements of our society to pay for  inexhaustible health care. 

What to do? We could, as most developed nations do, ration health care. We prefer to think we  do not have to do this, although we do informally ration a great deal—poor people receive lots  less of the best health care than rich people. 

I propose that, at the least, the U.S. and our states develop annual spreadsheets, maybe titled  “How’re we doin’?” The spreadsheets would tabulate expenditures, and ideally outcomes, for  each of the major functions of society: education, children, colleges, basic research,  infrastructure, and health care (this last maybe broken out by age categories, that is, young,  working age, senior). 

That way, if we spend ever more on health care for oldsters like me, we can see that. But we  should ring alarum bells if the breakout shows we are investing less on the more productive functions in order to do so. 

We cannot steal from young Peter to pay old Paul.