Needlessly Inflated Medical Costs

Medical care need not be so expensive. It could well be within the affordability of most people, with true charity covering the remainder. Other things which needlessly inflate the cost of medical care:

1. Needlessly long training tracks for practitioners before they can begin to return something of value from their training to that point.

2. Hanky-panky between the pharmaceutical industry and the FDA, keeping small competitors off of the playing field.

3. Maybe some naivete in patent law.

4. Undue restrictions in licensure.

5. The classification of many human problems, sins, and foibles into the medical model. Alcoholism led the charge in this. It causes many medical problems but has never responded to application of the “medical model” of disease, which is nonetheless very expensive.

6. Tax advantages to money set aside for “medical care” in the form of insurance premiums. People will spend it rather than lose it and thus distort medical markets, ascribing value to things which are not valuable. I will pick on a small, cheap target as example. The careful and systematic teaching of breast self-examination, intuitively attractive as a prevention of breast cancer death particularly in view of the fact that most breast cancers are found that way, has been shown NOT to prevent breast cancer deaths. Prostate cancer screening by any method likewise has failed. Screening for aneurysms of the abdominal aorta, likewise. The list is in the dozens. I know this is like spitting on the Mona Lisa, but I dare you to examine it carefully and scientifically.

We are prone to go at these things according to their face validity. A real free market would help hugely in sorting the useful out from the not useful, leaving each person at liberty to make his or her selections from what is available. Medicare, Part D, joins hands with other insurance in delaying the discipline of a free market. Senator Bill Frist, Senate Majority Leader, briefly floated the idea some weeks ago of giving everyone a sum of money, I think it was $300, to offset the rise in the cost of gasoline. Notice that giving the money sustains the cost of gasoline. It tends to make people refrain from carpooling, finding more fuel-efficient cars, consolidating trips, driving more slowly, taking public transit, etc. Just so does Medicare, Part D, sustain the high cost of drugs.

7. The imposition of managerial costs into medical billing, which averages something between 18% and 25%. Direct payment by the consumer strips this almost entirely away.

8. The imposition of regulatory costs into medical care. Medicare regulations alone run over 100,000 pages, with more pages on the interpretation and no agreement on that.

With correction of these and other costs, medical care is affordable to most people, and well within the reach of Christian charity.


Excerpt from "Medicare and Insurance"