Last week, for the first time ever, I paid for my health insurance directly out of my bank account; I wrote a check for $1200 to cover our health insurance for the month I am between jobs. For the last 30 years, most of the cost of my family’s health insurance was paid by my employer, and our share was deducted directly from my paycheck. That share was money I never really felt like we had, so somehow felt a lot less like it was coming out of my pocket than when I wrote a check for $1200.
More and more of America is coming to frame our excessive spending on health care the way writing that check made me see it, as the loss of opportunity to spend some of that money on things of greater personal and social value. Money spent on health care is money that could have been spent on food, clothing, vacations, early childhood development, roads and bridges, public transportation development, education, tuition support for young adults to go to college without incurring huge debts, research and development, and much more.
Health care costs are at the root of the federal budget debates, and a huge contributor to federal budget deficits and the national debt. Spending on many other areas of government and social programs is flat — it’s primarily spending on Medicaid and Medicare that is making the work of governing this country progressively about brutally difficult choices among lousy options to cut costs.
There was a time when spending all of that extra money on health care seemed to most of us like a good choice. Better health care for people, after all, was more important than better roads or bridges, or almost anything else. The health care industry has gotten a lot of deference because we are in the business of caring for patients, we supposedly know best what patients need, and patients often rallied to our cause when push came to political shove in spending battles.
But America has learned the dirty secrets of health care, the most important of which is that the idea we could not get better health care unless we spent more on it is a false choice. It is false because so much of what we spend on health care is wasted, and because, for all we spend in America on health care for most of us, other countries get better health care for all of their citizens for a lot less money.
The growing awareness of this false choice is giving rise to a growing anger among those who suffer the consequences of inadequate spending on other parts of our society (schools, business investment, etc). When I talk to many business owners and leaders now, more and more of them are sick and tired of waiting for physicians and others in the health care industry to get their acts together and control health care spending so they can spend more of their companies’ money on other things. They are ready to take drastic action on their own to cut their spending on health care.
The anger is growing among our political leaders, too — the ones who are forced to make ugly choices for us about where to cut spending on other things because government spending on health care grows every year. More and more of them are pointing at the health care industry — hospitals, physicians, pharmaceutical companies, etc. — and saying “Enough — you people are the problem and we are just going to put you on a budget diet until you figure out how to do a good job taking care of us for less money.”
America wants back the countless billions it is spending on health care unnecessarily. It is going to battle the health care industry (and to some extent itself) to get them back in order to be able to spend those dollars on other things. It will be an epic battle, because that means cutting jobs, incomes, investment, tax dollars, and businesses from the health care industry in order to transfer jobs, incomes, investment, tax dollars, and businesses to other parts of the economy. Smart people in health care get this, accept this, and will thrive. Some of the rest of the industry will be looking for work.
Erik Steele is the former chief medical officer of Eastern Maine Healthcare Systems. He recently accepted a new job at Summa Health System in Akron, Ohio.