Glenn A Knight

Glenn A Knight
In my study

Sunday, August 23, 2009

Health Care Costs - A Blast from the Past

After my previous post on this subject, on July 27, 2009, a friend wrote to point out that the US pays much more for healthcare than does France, and yet our measures of health outcomes are worse than those of the French. Is this a sign of a bad healthcare system?

As I pointed out in my earlier post, a lot of the cost factors are due to internal processes within the healthcare system. I also noted that universal insurance would, by increasing demand, tend to increase the price of healthcare.

In the comparison with France, we see another factor driving demand.

As regards the better health outcomes in other countries, such as France, a lot of people use that figure as if it were due to the health care system. Actually, a lot of that effect is due to people's behavior which keeps them out of the health care system altogether. For example, we don't have more people with diabetes because the medical care system treats diabetes patients badly. We have lots of diabetes patients because people pursue patterns of eating and exercise which lead to Type 2 diabetes. If they didn't do so, they wouldn't get into the health care system at all.

I tend to look at the medical care system in conventional economic terms, although I'm aware that there are some interesting anomalies in that system. If demand for services goes up, then the price will also rise. If, therefore, people in country X have a healthy lifestyle, avoid obesity, eschew risky behavior, their demand for medical services will be low, and the price of these services will also tend to be low. If the people in country Y eat too much, exercise too little, and subject themselves to chronic diseases, then they will end up demanding lots of medical services, and the price of medical service will rise.

I might also note that 80% of medical costs are attributable to a rather small number of elderly people. Thus, the miserable health outcomes numbers, and the high price of medicine, are due to people smoking, drinking, eating too much, eating the wrong things, and living sedentary lifestyles in the 1950s and 1960s. Lacking a reliable time machine, there isn't a whole lot we can do to remedy that situation.

Going forward, I might note, the health care system, as presently constituted, is not responsible for stopping us from eating fried chicken, which may be, with smoking, the single largest risk factor for diabetes, high blood pressure, and high cholesterol, which are, in turn, risk factors for heart attacks and strokes. Maybe the department of Health and Human Services should take on that task, including the fight with the department of Agriculture which is busy promoting the sale of unhealthy food. But the medical system isn't going to solve our social problems.

3 comments:

Ken Roberts said...

Hi Glenn...

You might want to look up Michael Pollan, if you are not already acquainted with his writings.

For example, from an interview transcript in early July, asked whether the Obama administration will be supportive of his goals:

"We don't know yet. I think Obama gets the issues. He's a great dot connector. He connects the dots between the way we grow food and the health care crisis and the climate change crisis and the energy crisis. He understands that and he's spoken about that eloquently. The question is how much political capital he is going to put into changing the system."

Pollan's thoughts re food and health are stimulating.

Best,
Ken

Glenn Knight said...

Ken, your timing couldn't have been worse, man! On August 25 my daughter went back to Argentina after six months here, so the previous week was full of farewell parties and stuff. Then, on Friday, August 28, our friends from North Carolina flew into Denver. So from August 29 through September 4 we were on the road to several national parks and national monuments in the Four Corners region - Colorado, Utah, Arizona, and New Mexico. A very nice trip, but I was out of contact much of the time.

I know something about Pollan, though I haven't yet read any of his books. An interesting guy. It's a real problem, though, selling an holistic viewpoint in a world of linear thinkers.

One friend of mine thinks it would be great if we ran out of fossil fuels tomorrow, because he is totally focussed on global warming. But another friend thinks we've become so dependent on petroleum to produce our food that we are headed for a population crash.

Ken Roberts said...

Family activities and trips are not to be missed! Sounds like you had a great time. Argentina sounds OK. Have you tried the wines from the Mendoza region?

"A world of linear thinkers" is about the size of it. Big problem. I think the internet may be a net positive though - although it is a context within which a linear thinker can pursue a monomania with like-focued others, it also provides lots of lateral thinking opportunities. Sometimes too many it seems. But the challenge will create coping mechanisms, which in practice will mean more subtlety in the survivors. Linear thinkers will be a disadvantaged variety.

Regarding food production, in this area we are doing more growing in greenhouses - my apologies if that has been mentioned before - and CO2 is injected to accelerate the growth. Good carbon sink even if temporary, and very land efficient.

My own suggestion is microbots to do cultivation at the plant level. Release them into a soybean field, contain via an electric fence eg, and will have a weed free field, proper water and nutrients to each plant, etc. Solar recharged.