It is well known that the American health care system needs a great deal of change. Health care reform was a campaign for President Obama when he championed the Affordable Care Act, Senator Bernie Sanders has long called for the implementation of a single-payer system, and recently Republicans have advocated for the shrinkage of healthcare spending in the American Health Care Act that was proposed in March of this year. However, these are all proposals to change how the government pays for the healthcare of the American people.
The problems that face our health care system run much deeper than whose pocketbook the bill gets written to. In 2014, three trillion dollars were spent in total on healthcare in the U.S. which accounts for 17 percent of the nation’s GDP, the highest of any developed nation regardless of the structure of their pay system. To me, it seems like less of a problem of which system is implemented and more of a problem with the health care costs in general. So, why is healthcare so expensive?
Doctors are expensive. In order to become a doctor it takes years of schooling and experience, which isn’t necessarily a problem but it means that physicians and medical practitioners rack up a larger debt than the national average and carry that debt for a longer period of time since it takes eight years for most medical degrees. Due to this, many general practitioners can find it hard to pay for the debt from their education, which can force them to seek higher paying positions. This phenomenon has caused many American doctors and physicians to specialize their practices in order to get more money, which artificially raises prices and has begun to create a scarcity of general practitioners.
Drug manufacturers are allowed to lobby doctors and advertise to consumers. It’s a common practice for drug companies to send representatives to hospitals and doctor offices to cut deals for new drugs. The companies make deals that the medical staff will prescribe their drug more often and share in some of the profits. This artificially drives down market diversity and can lead to the current state of many drugs where there is a near monopoly. These same companies often advertise directly to consumers, which has been known to lower the chance of consumers buying the generic version of a drug. Also, since many medical staff share in the profits of certain drugs, it leads to many of these drugs being overprescribed when the patient may have only needed a little or none at all.
Overuse of technology is another contributor to rising healthcare costs. Unique to the United States is an extremely high rate of use of medical technology such as MRI, X-ray, etc. It’s unknown why technology has been used so much, though it may be due to the lack of medical staff to interact with patients in a meaningful way or the perception that it will help find medical issues. This overuse can cause problems since it is not actually needed for many people and drives up healthcare costs.
Other problems include the lack of preventative care, causing most of the care in the U.S. to be curative which is more expensive than preventative, as well as the unhealthy eating and lifestyle habits of Americans.
In my opinion, the solution to this would be to attempt to solve the problems of the medical industry. Make profit sharing with doctors and medical staff illegal, block direct drug advertising to consumers, and increase preventative care funding. More importantly a bidding system could be created to allow drug companies to bid for lowest prices for drugs and be guaranteed a percentage of the market based on their bid; a similar system has been implemented in the U.K. In order to combat the high costs of education the government could implement a system where medical education was free to students who would become general practitioners and agreed to work in those positions for a period of time, slowing overspecialization.
