In an opinion in yesterday’s New York Times (November 29, 2013), Paul Krugman shares some optimistic thoughts about the slowing down of the rate of increase in health care inflation.
Let’s look at that sentence more carefully: slowing- down- the- rate- of- increase. In my opinion, this does not go nearly far enough. Every other industry has experienced dramatic change over the past several years. People have seen their home lose 30% or more of its value. The replacement cycle on cars and heavy equipment has become dramatically longer. Deep discounting has become the norm throughout the retail industry.
But all health care can do is slow down the rate of increase?
What concerns me most is that we are about to “bake this number in” to the national budget, permanently, with no end in sight.
While I am a strong supporter of Obamacare, and some number must be budgeted and planned for, what concerns me is the size of the number we are now prepared to take for granted.
It is widely known that the US spends more per-capita on health care than any other country. By a wide margin. In fact, the US spends 50% more than the second most expensive country (Switzerland) and two and a half times what the average OECD country spends. And we die younger.
So simply “bending the cost curve” is not enough. We need to radically reduce the overall costs of care by a substantial number. Like 30%.
If we reduced our per-capita costs by 30%, we would still have the most expensive system in the world. And we would still die younger. But maybe the rest of the country would be allowed to move forward as health costs no longer crowded out education, infrastructure and a host of other social programs.
If we reduced our costs by 30%, we would still be 80% more expensive than the OECD average. And we would still die younger.
Now, is 30% the right number? I cannot say, as no one else can, exactly what the right number is. But the point I am trying to make is that we need a drastically different dialogue, with a target drastically different than the status quo. Bending the cost curve is playing around at the edges. We need a radical fix, a radical reduction in costs, and the will to build and implement such a health care system.
What do you think?