Friday, July 27, 2012

A Trend Will Continue Until it Can't

Reading an op-ed piece, that wasn't bad by any means, in the Washington Post inspired a desire to ask for some sense in discussing health care costs.

From Forbes

Scary graph and all, but does anyone really think this is sensible? Continue this graph out and some time in the 2100s health care spending will exceed 100% of GDP.

Rather obviously, this doesn't make any sense. The current trend won't continue because it can't, whether or not we have health care reform.

This isn't to say that reform isn't necessary, that we don't need more doctors, or that we shouldn't be worried about the problems. However, the sharp trendlines and high cost increases are just noise, they simply aren't possible. If Medicare spending gets cuts few doctors will be able to cease seeing Medicare patients, for many doctors those over 65 make up the majority of their patients. You can't make any money by not seeing anyone. In the end, what we are discussing with health care reform is who is going to be paying for forced changes, not whether or not current trends will continue.

I think this is critical to keep in mind when discussing health care. There is no solution where everybody wins, current trends, and thus current power arrangements, cost structures, and winners and losers, cannot be the same because the current trend is unsustainable. What we are debating is who wins and who loses. This is why the debate is so fierce, no one wants to be the loser. This is also why everyone should be very skeptical of claims made and aware of framing, everyone has some skin in this game so expect dishonest presentations from just about everyone involved in the health care debate.

1 comment:

  1. I think it is perhaps more the case that the current discussion is so fruitless exactly because everybody wants to be sure that, whoever loses, it won't be them.** For the moment, enough different groups have an effective veto that nothing is produced except hysterical rhetoric.

    As you say, that cannot last. But it will continue long enough to make the eventual resolution far more painful, to far more people, than it need have been.

    ** there are different ways to justify their positions. In some cases, it is pure denial of reality. Others make do with ignorance.