NCPA - National Center for Policy Analysis


September 11, 2008

The central problem concerning health care is not improving coverage, its controlling costs.  In 1960, health care accounted for $1 of every $20; now that's $1 of every $6, and the Congressional Budget Office projects that it could be $1 of every $4 by 2025.  Will we be better off with a quarter of the U.S. economy devoted to health care?  Probably not, since countless studies have shown that many diagnostic tests, surgeries and medical devices are either ineffective or unneeded, says columnist Robert J. Samuelson.

Moreover, it is widely assumed that health care, like most aspects of American life, shamefully shortchanges the poor.  However, this is less true than it seems, says Samuelson:

  • On average, annual health spending per person is equal for the poorest and the richest Americans.
  • In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest.
  • One reason for this equality: the government already insures more than a quarter of the population, including many of the poor.
  • Another reason stems from the skewing of health spending toward the very sick and dying; 10 percent of patients account for two-thirds of spending.

This group includes the uninsured, and their care is estimated to cost about $86 billion this year alone.  And even though the uninsured pay about $30 billion themselves, the rest are uncompensated.  However, the data concerning care is contradictory.  Some studies say that the uninsured receive less care and suffer abnormally high death rates; others suggest only minor disadvantages for the uninsured.

Bottom line: we need more realism on health care, says Samuelson.  The trouble with casting medical care as a "right" is that this ignores how open-ended the "right" should be and how fulfilling it might compromise other "rights" and needs.  Health care, no matter how lavishly provided, can only partially compensate for individual differences, concludes Samuelson.

Source: Robert J. Samuelson, "Getting Real About Health Care," Newsweek, September 15, 2008.

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