Over the years I have opined that health care costs are increasing because we do more things to improve quantity and quality of life. While I believe (and I am not unique here) that I could personally design a health care system that would save some dollars, I could not prevent health cost inflation.

As a society we have to decide if improved health is worth an increasing proportion of our income.

This NY Times article poses the question clearly – The Choice: A Longer Life or More Stuff

There is no question that the American medical system does suffer from a lot of waste, be it insurance industry bureaucracy or expensive procedures that haven’t been proven effective. But the No. 1 cause of the cost increases is still the one you can see at the hospital and in your medicine cabinet — defibrillators, chemotherapy, cholesterol drugs, neonatal care and other treatments that are both expensive and effective.

Not even most forms of preventive care, like keeping diabetes under control, usually save money, despite what many people think. The care itself has some costs, and, more important, patients then live longer than they otherwise would have and rack up medical bills. “When I make this point, people accuse me of wanting people to die earlier. But it’s exactly the opposite,” Dr. Jay Bhattacharya, a researcher at Stanford Medical School, told me. “If these expenditures are keeping people alive, it’s money well spent.”

As Dr. Mark R. Chassin of the Mount Sinai School of Medicine in New York says, “You almost always spend money to gain health.” Of course, the opposite is also true: the best way to reduce health care spending is to reduce health care itself.

Health care delivery is not static. As we improve our armamentarium, we must understand that new drugs and diagnostic tests are expensive. I believe the money is generally well spent.

The important issue here is that we understand the trade-off. We cannot cut health care spending and then complain about decreasing health care quality. We can save some moneys by actually increasing payments for family physicians and general internists. They do a better job of curtailing unnecessary costs. The problem is in defining necessary and unnecessary. And that task is much more complex than we would easily admit.

It’s easy to be against high costs, and it will no doubt be hard to come up with a broad health care solution. But the way to start is by acknowledging that an affluent society should devote an ever-growing share of its resources to the health of its citizens. “We have enough of the basics in life,” Mr. Cutler, the economist and author, points out. “What we really want are the time and the quality of life to enjoy them.”

Please read the entire article, as it raises very important philosophical issues.

Related posts:

1. Thoughts on health care costs
2. Understanding health care costs
3. Understanding increased health care costs
4. We need health care reform
5. Increased health care costs

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