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What You Won’t Hear on the Campaign Trail

July 13, 2015

I’ve been listening to some of the campaign speech summaries recently, both on the Republican and Democratic sides. A common theme is a stagnant middle class with shrinking jobs and a growing wage gap compared to the wealthiest few percent of Americans. The politician’s silence on a key set of facts is notable.

In 2011, the Rand Corporation published a study estimating that if healthcare costs had grown at the general inflation rate since 1999, workers would have about $5000 more income by 2009. The authors estimated that 79% of household income growth was siphoned off into the healthcare industry. Similarly, Dr. Jennifer DeVoe and I estimated a potential $8600 increased yearly income from 1996 to 2010, if health insurance inflation had equaled general inflation.

Will politicians from either party challenge voters to improve their lives by taking on the status quo of the healthcare industry? Will they name expensive cancer treatments, excessive testing, excessive medical technology, unnecessary procedures, and an imbalanced physician workforce as the primary cause of the middle class’s angst?

I’m not holding my breath on this one.

I’m trying to gird myself for 1 ½ years of empty rhetoric from both parties prior to the presidential election. What little talk about healthcare reform will occur will sure consist of statements of wellness, prevention, early detection, and keeping people healthy. All the major healthcare industry funders will surely pressure the campaigns to preach this comforting but meaningless message.

I know this is coming. I’ll try to let these statements just roll off my back. It’s just frustrating and depressing to think about.

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2 Responses to What You Won’t Hear on the Campaign Trail

  1. Jenna B on July 14, 2015 at 8:11 am

    I you really can’t lay the entire expense on the healthcare industry. Do individuals have no responsibility for their own obesity and sedentary lifestyles? if you resist putting any of cost on individual choices lthat lead to expensive chronic diseases, at least let the FDA, ( and the food and drug marketing we allow), the USDA , and the food industry “eat” some share of this cost. Patients are pushing for pills and surgeries to solve what their lifetime lifestyle choices have wrought, be it insulin, Viagra, a new stent or chemo I’d say demand push is equally at fault here. The heart of this is a societal values problem. We value capitalism and self indulgence in all forms over greater Hunan needs.

    • Richard Young MD on July 21, 2015 at 11:37 pm


      Sorry for the delay in posting this. I agree with your comments, for the most part. I think the greatest missing concept in most pundits’ statements about what is wrong with U.S. healthcare is they totally take the public/patients out of the equation. Their expectations are what start each healthcare spending journey. Values and priorities are what we really need to talk about, including the role of other societal institutions in promoting healthier lives: safe neighborhoods, good schools, etc. On the other hand, I believe the typical CDC-type stats on the cost of obesity is exaggerated. If everyone got skinny, it would delay the onset of heart disease, e.g., but not change the final outcome as much as a lot of people think. You can read more about all this in my book 😉

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