America: What Part Of The Healthcare Cost Crisis Do You Own?

By:  The Musing Medic (@TheMusingMedic)


Over the past few years, health care expenditure has come to the forefront of American consciousness. Turn to any channel or examine any newspaper headline and you’ll see something pertaining to the rising cost of healthcare. Pundits, regardless of political persuasion, have something to say about the Affordable Care Act, also known pejoratively as “Obamacare”. There is certainly no dearth of opinion on these matters, and numerous entities are blamed for the current “crisis”.  Candidate culprits include big-business insurance companies, bottom-line focused hospitals, and greedy physicians, but…


The Players Didn’t Make Up The Game

While these groups do own some culpability, they are not the catalyst that spurred the issue. Rather they played the game in which they are participants. The adage goes “hate the game, not the player”. So who then is to blame for sparking this wildfire of excessive health care costs?


The general American populous.


That’s right, I said it.


Mr. & Mrs. John Q. Public are to blame for the exorbitant cost of modern health care.  At least partially.  And yes, that’s me and you.


But how?


The Stats Tell Us The Story…

Let’s take a look at some basic statistics:


37.5% of American adults are classified as obese

17% of American children are classified as obese

Source: CDC 2010


18.1% of American adults smoke cigarettes

Source: CDC 2012


80% of American adults do not exercise the recommended amount

Source: CDC 2012


Those are some basic statistics regarding three major components of a health profile. Naturally, all three are related to one another–especially in the cause-effect realm (eg lack of exercise can lead to obesity). There is a myriad of other healthcare issues, such as illicit drug use, poor diet, and so forth. Additionally, there are socioeconomic factors such as income, race, religion, and geography that can affect one’s health and even their access to health care. …however, that is another discussion for another time.  Perhaps I’ll cover those in my next entry.


Does it cost more to take care of an obese smoker?  Absolutely.


This post is all about holding the American public (all of us) accountable for our choices and actions that lead to higher costs.


How about we just take into account the three aforementioned modifiable lifestyle choices? All three can lead to significant health issues such as hypertension, diabetes, coronary disease, stroke, heart failure, renal failure, COPD, and more. Any of these conditions lead to adverse outcomes, disability, and (generally speaking) a significant financial cost.


Yes, we can say that medical errors cost us all a lot.  (And we should try to eliminate errors!) When a healthcare provider makes a mistake, we do all sorts of things like complain, bring suit, etc.  But listen:  when we’re morbidly obese there’s less wiggle room for errors.  Errors are, arguably, more likely when we require many more procedures than we would have otherwise needed owing to our obesity or other comorbidity.  There’d be no error, or at least we’d have less errors, if we weren’t so large that placing central lines or intubating us wasn’t that much harder.  Yes, healthcare providers (like me when I’m in the field) can get it done, but things would go right so much more easily if we, as Americans, helped out a little.


A lot of the trouble is the expectation, from all of us as citizens, that we will be taken care of without any problem despite whatever situation we may have gotten ourselves into.  No matter our size, smoking, or alcohol abuse, we expect healthcare where the procedure that is done to us (for us) simply must go right.


Help us (and yourself) out by avoiding lifestyle choices that paint healthcare providers into a corner when they show up to help.  It would make things easier on you and much safer.


Aren’t Insurance Companies Really To Blame?

It turns out that insurance companies use premiums to pay a large portion of their customers’ health care costs. The more medical conditions a person has, whether by genetics, lifestyle choices, a combination of both, or just dumb luck, the more likely it is that the patient is going to need medical care. And that medical care costs money. So, as the American population continues to go gray (i.e; baby boomers), the greater the need will be for medical care. Add in that there is an ever-rising number of persons under the age of forty-five with cardiac disease, respiratory conditions, and diabetes, and the issue compounds. Insurance companies have been forced to increase premiums to keep up with the needed expenditure. Additionally, hospitals and physicians have needed to raise their prices to keep pace and maintain staffing and proper equipment.


Is the story that simple?  Not really.  But the fact is that a sicker population means more expense.  Maybe insurers would have less of an excuse to raise prices if we all were just a bit healthier…


Imagine if those statistics mentioned previously were halved. What would happen? Would health care costs decrease?


I’m not sure I know that answer. More importantly it’s a moot point. You could hire an actuary to run those numbers along with economists, financial advisors, and health care administrators and still not have a clear cut answer. What is done is done.


…and I am not sure there will be anything but rising costs in the future. Like I mentioned though, this entry is not about finding an answer. It is about pointing a finger at the main offender, the ones who caused this “crisis”. That would be Americans like you and me.  (Hopefully, for your health, not you specifically!) Before citizens blame everyone around them, they should look in the mirror and ask themselves if they have contributed to the cost of health care in a negative or positive way. I doubt many would be pleased with the honest answer.


Agree?  Disagree?  Let me know beneath.


Till next time


The Musing Medic