Paying More for Less; US Healthcare in a Nutshell

health care spending

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There has certainly been no shortage of discussion on who should pay for healthcare in this country.  But never once has anyone seemed to question whether or not who pays is the problem.

This is the exact topic that the entire Obamacare administration will be known for, for good or for ill.  To date, however, the discussion has been all about the financial side of health care and not the efficiency and efficacy of health care.

There are unquestionably people who believe that health care is a right and should be provided for everyone, regardless of financial means.  If they can’t pay for it, someone else who does have the money should foot the bill.  And if you’ve happened to fall into a discussion with someone who believes this way, it can be a difficult one.  I should know–I have a close family member who feels this way.

The argument that health care is a right is purely an emotional argument because when you try to look at it from a logical standpoint it just does not make sense.  I have said time and time again that we cannot afford healthcare for a population that is one of the sickest in the developed world and has a sense of entitlement that is second to none on this planet.

We want MRIs, ER visits, that new medication we saw on TV, we want very expensive and toxic cancer treatments that will provide additional life extension measured in weeks and we want it all without a wait.  Even worse, we want all of our medications in lieu of making simple lifestyle changes that would otherwise completely erase the need for that new fancy medication.

Our health care system is broken and it has nothing to do with who’s paying.  If we want to meet halfway, what about making the diabetic exercise routinely and avoid processed foods, refined carbs and hydrogenated oils in order to have his or her medications paid for?  Does this sound unreasonable?  It will to those who do not feel like personal responsibility should be a requirement for getting your healthcare paid for.

I had a patient in the other day who, prior to the Affordable Care Act, paid $3 or 4,000 a year in premiums for him and his wife (I can’t remember which one it was).  After Obamacare, they are still paying the same amount of money for the same coverage, but the REAL price tag on the premiums is something like $11,000.  He gets a massive subsidy to pay for his health insurance premiums.

Those of you who were never good at math would look at say how wonderful everything is under the Affordable Care Act because now this person can get insurance.  On the other hand, those of us who did pay attention in 4th grade are scratching our heads trying to figure out where the extra $7 or 8,000 went?  Who gets this extra money??  We all know who is paying for it–all of us.  But who is making the extra money??

I just don’t understand it.

Just in case you still don’t get my point, I bring you this particular study looking at life expectancies based on GMP of countries across the globe.  Here are some interesting points:

  1. It is clear that higher healthcare spending (as a percentage of GDP) does NOT lead to higher life expectancies.
  2. Among the 25 highest income states in the US there is also no correlation between higher spending and life expectancies.
  3. Among the 25 poorest states, higher spending actually leads to LOWER life expectancies.
  4. Colorado, the state that spends the least on healthcare, STILL spends more (again as a percentage of GDP) than the Netherlands on healthcare.
  5. To put it clearer, if the US controlled health care spending to match that of the next highest country, there would be an extra TRILLION dollars to spend elsewhere.

And remember, all of this spending is not getting us anywhere.  We are the most medicated country on the planet (we consume a massive 52.9% of the WORLD’S prescription drugs) and it’s getting us nowhere except more sick.


James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


Please note: I reserve the right to delete comments that are offensive or off-topic.

2 thoughts on “Paying More for Less; US Healthcare in a Nutshell

  1. It should be pointed out that countries with better outcomes and lower costs usually don’t have for profit healthcare systems like we do here.

  2. I have a real issue with the right wing use of the word “entitlement” in reference to taking care of our nation’s needy. We live in a country where the wealth is distributed in a way that is anything but fair. Consider the CEO who makes 10,000 times more than his managers and workers. And then consider our teachers or other social/healthcare workers who make so much less. My mother started a non profit school that has worldwide recognition and she barely made a livable wage. I consider helping out with needy people’s healthcare needs to be DECENT, as in the DECENT thing to do.
    I don’t think that everyone wants all of the stuff you mention (MRI’s, latest drugs, etc.), many just want to not suffer anymore and get basic care. There may be some that want the latest/greatest on everyone else’s dime, but I really don’t think that is the majority. Maybe it would be clearer if you walked a mile in someone else’s shoes….you might see that it’s not about entitlement at all for most people. Imagine becoming disabled all of a sudden, etc. It’s something people can’t imagine until it happens to you.
    I completely agree with you about our medical system being broken. I also feel anyone getting assistance should be making other changes to get healthy and not relying on our pathetic system of pharmaceuticals with no lifestyle changes. I think the problem is that so many are not educated, and they think their doctor is the expert and they should follow the plan given to them by their doctor. I think this is an educational issue. I don’t think this is about personal responsibility but more one of ignorance. Maybe some really are the lazy entitled folks you claim they all are, but I think most are not. Again, I’d like to see this right wing group who feels this way walk a mile in other’s shoes. Become incapacitated in some way, have to go on long term disability, and see what it’s like for people to assume you are entitled and lack personal responsibility. You might be surprised. Some people just need help. Many are ignorant to what you really need to do to be healthy since doctor’s aren’t teaching people that. Plus, if you go the alternative route, it is so expensive and not even covered under health insurance and many can’t afford to do that. How easy it is to label people you don’t even know.
    P.S. When we close the door to people in need, we become a 3rd world country. I think that would be an embarrassment to a country like ours, though we are seemingly headed this way with our growing massive income disparity.

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