Varied and deep rooted (cost of health care)

I’d just add a few observations to the New York Times editorial (free registration required) on the cost of health care in the US.

I’m a big proponent of making patients responsible for more of their health care costs. Health Savings Accounts, long term care insurance, and even deductibles are good ideas. I would also add that the vast majority of the people on Medicaid and public assistance could do some sort of public service work in payment for their health care. (Medicare, disability, and veteran’s health care has been paid for already.)

I especially like the idea that primary care should be emphasized. How about *paying* doctors to do it instead of ensuring that we lose money for every Medicaid and Medicare patient we see?

And they don’t mention some of the problems that I see:

1. Over the counter medicines that probably aren’t needed in the first place and don’t do what they are believed to do. Did anyone notice that the baby cold medicines are not useful and no longer standard of care? And please don’t get me started on homeopathy – I’ll irritate a couple of million of my readers if I go on about the useless idea that a substance diluted millions of times in water can’t do anything.

2. Botox, cosmetic surgery, and beauty treatments – Do these services, when provided by a physician go into that giant number?

3. The hidden costs of school-based health care and the need for “notes” from doctors for school and work. I doubt that many people are aware of how much of Medicaid money is spent on “mainstreaming” and on learning disabilities in our school systems. I’m sure that few would understand the pressures that doctors face to provide the testing, medications, and follow up required to get mom back to work after the baby is too sick for daycare or school, for the note for the Tuesday patient who says they had food poisoning on Monday, or for the demand from a school or from the parents to get the 7 year old tested for a learning disability for all sorts of reasons.

4. Salaries and perks for insurance big wigs that could pay for the healthcare system of a couple of nations. United Healthcare, which threatens to swallow up every insurance company in the nation, has paid at least $120 Million dollars to its CEO for at least 10 years.

5. I don’t want it to go away — but — Medicare pays for quite a bit of the research and medical education in the country. We need to see this research and the doctors, medicines and treatments that come from these funds as the valuable commodity they are and quit dinging “health care costs” for it.