btw2.net

Today The Health Care Blog has a post - The Perpetual Health Care Crisis By Jeff Goldsmith.
It begins:

I began teaching health policy almost thirty years ago with Odin Anderson at the University of Chicago Graduate School of Business. Like me, Odin was a sociologist, and one of his hobbies was tracking the sociology of our nation’s “healthcare crisis”. He found that the health care “crisis” waxed and waned (as measured by press mentions and journal articles), but never disappeared. It had been going on for twenty years by then, so I guess we’ve now been in “crisis” for fifty years. The American health care “crisis” is not acute illness - rather it is like a chronic disease which flares up periodically, accompanied by fresh prophecies of impending doom and calls for someone on a white horse to fix the problem.

From 1970 to 1993, health costs roughly doubled as a percentage of GDP. All the way along, prophets of doom forecast that the country would simply fall apart when health costs exceeded 8%, then 10%, etc. . Our economy somehow continued growing and innovating, and the health system got steadily more capable at managing our illnesses the entire time. No-one I know would trade our present, very expensive health system for the cheaper one we had in 1965 or 1980….

There are several things to keep in mind as we delve into our “crisis”:

1. Medical care is not the same as health care. Health care involves illness avoidance as well as the treatments of medical care.
2. Many leaps have been made in both medical care and health care.  And, like Jeff Goldsmith, I wouldn’t got back to 1965 or 1980 for cheaper health care.
3. Some folks rely on their doctor to keep them healthy. The doctor can help but the “patient” does much of the health benefit effort by managing their lifestyle. (yes, heredity can short circuit all of that. but try anyway.)
4. While the cost of health care has gone up, the practice of medicine has changed dramatically. Some doctors are still trying to manage their practice like its 1980. The doctor and their patients are ill served by that lact of a progressive effort.

And I’ve found value in the ideas in this book.