3 Ways to Bend the Health Care Cost Curve

My sister in-law, a Doctor with a career in public health is visiting and we had a discussion today about what it would take to bend the health care cost curve to prevent it from bankrupting the country.  She has a unique view on this having spent her career in public health in Appalachia, but living in city with high quality medical care.

1.  Educate people about end of life care so intelligent decisions are made.  Everyone should have a living will so desires are clear and people don't get thrown into the fee for service system when they are unable to make decisions and worthless care is provided because it will be reimbursed.  Such service also keeps the hysterical daughter happy, so she doesn't sue, when Momma dies.  There is also a culture of "do whatever it takes" to keep someone alive even when the odds of doing anything beyond extending a low quality life for a few days, weeks or months are the only possible outcome before death.  That needs to change.  For anyone interested in how to do this better, read The Best Care Possible by Ira Byock.

2.  Educate poor people that when something is needed, go get it taken care of .  Don't let it fester and become something worse and more expensive.  There is a culture in the less wealthy reaches of the country that the Health Care system will fix me up when I need it.  They don't get it taken care of when it might be simple and less expensive, they wait until it has to be taken care of.  This might be because they don't have health insurance, or they cannot afford the co-pay, or they just simply cannot be bothered.  More wealthy people know you get things taken care of early.

3. Work to reduce teen pregnancy.  This is a problem of poverty which pervades the 1st two points.  Teen pregnancy perpetuates poverty and added $11 billion to the taxpayer funded medical cost in 2008.
Each teen pregnancy funded by the public health care system costs the taxpayers between $25,000 and $30,000 depending upon the states.

Note:  Nothing the GOP proposes in terms of introducing competition into Health Insurance addresses any of these issues.  The For-Profit Health Insurance System created the Fee For Service system and does not work for anyone who does not get Health Insurance through employment.  Obama Care puts in place programs that address all 3 of these issues, but much education will be needed to change the culture.  You also need to address medical malpractice which stands behind Dr. acquiescence to hysterical poor daughters who would love to get rich off a malpractice suit for letting diabetic 250 lb Momma die.