I believe healthcare in the U.S. costs too much.
I believe the excessive cost of healthcare is a significant burden for American businesses and governments. For businesses, this leads to reduced wages, fewer available jobs, and millions of Americans stuck in jobs they don’t like merely to keep their health insurance. For governments, this leads to budget deficits and requires revenue to be generated from other sources such as raising college tuition, cutting other services, and raising taxes.
I’m a family physician and I believe physicians are part of the problem. I don’t think any physician organization has engaged the American people in a serious discussion about the appropriate role of the healthcare system in our society.
I believe health comes from many other sources than the formal healthcare system. The solution to someone who’s depressed because he’s been out of a job for nine months isn’t an anti-depressant pill, it’s a job.
I believe there are many special interest groups in U.S. healthcare that perpetuate the status quo and block meaningful reform efforts. They do this because of a complex blend of heartfelt beliefs in the importance of their causes and blatant protection of their self-interests. The primary reason U.S. healthcare costs have risen faster than the general inflation rate for four decades is that all these special interest groups think alike. But their beliefs are sometimes wrong.
I believe the special interest groups commonly scare the American people into buying healthcare services they don’t need. I am calling for “health scare” reform.
This website and blog are for people who believe American healthcare costs way too much and are willing to consider a few radical ideas on how to fix it.
The primary solution to expensive healthcare is that the relationship between doctors and patients must change. The current relationship between doctors and the American public – that all possible healthcare services be provided no matter how rare the benefit or expensive the service – is unsustainable. Until we accept this reality, healthcare costs will continue to rise faster than personal incomes and soon health insurance will be available only to the very wealthy. The great American healthcare irony — we spend the most but get the least — will only get worse.
The two important questions that must be answered are — What level of risk is too low to worry about? and When does a healthcare service cost too much to provide? Until we answer these questions, rampant medical inflation will never end.
When a patient sees me for a new symptom, should I order every test that could possibly diagnose the symptom or initially focus on the most common causes. When a patient has finished two rounds of debilitating chemotherapy without much success, should I encourage more treatments or say, “Pam, I think it’s time to focus on keeping you comfortable and getting the most out of the time you have left.”
These are difficult questions, but they must be answered to bring a sense of proportion to our dysfunctional healthcare system. Thank you for your time and thoughts.
Richard Young, MD