Another reason we spend so much on health care

We hear lots of reasons why the U.S. spends so much on health care. But, there’s one obvious reason that I don’t recall hearing all that often.

On a recent EconTalk podcast, guest Esther Dyson offered this reason:

…one reason health care costs so much in the United States is that we are so unhealthy.

Could be.

It would be interesting to break down health care spending across various indicators of a person’s health to see if there’s anything to that.

2 thoughts on “Another reason we spend so much on health care

  1. “WE” (as a nation) spend so much on healthcare because “we” (as individuals) think that somebody else is picking up the tab. In some cases (Medicare & Medicare) , “we” are correct. In others (employer “provided” healthcare insurance), this is simply an illusion. When the recipient of goods or services no longer believes that he must choose between cost and quality, quality becomes his only concern and it’s “Katy bar the door” for prices.

    As far as healthcare spending as a function of one’s REAL health, I doubt the correlation is what one would expect if the consumer was directly purchasing the service. What we have seen in the US is that when this direct connection is missing, people will not only seek “care” for trivial or non-existent problems, they will accept/demand treatments whose cost is far out of proportion to the “discomfort” caused by the original ailment.

    Furthermore, I contend that as long as one is taking financial responsibility for one’s own medical bills, it should not be the concern of Ms. Dyson whether that person is healthy or not. That’s a significant concern when government assumes responsibility for your healthcare – once the costs start escalating, the government will feel it also has the right to curtail your unhealthy behaviors.


    This isn’t just a conspiracy theory, it’s already happening. ObamaCare allows smokers – especially older smokers (remember, the younger ones are more likely Obama supporters) – to be discriminated against when purchasing health insurance. But wait, if they can’t discriminate against fat folks and people with some pre-existing condition, why can they discriminate against smokers?

    Easy. Smoking has always been the boogie man for politicians because the tobacco companies have been vilified by the left as evil and greedy. Fat is hard to pin down to any particular industry and like some (not all) pre-existing health condition, it’s often viewed as a failure of personal responsibility rather than something attributable to the aggressive advertisements of some evil corporate giant

    I don’t think the ObamaCare geniuses have though this through though and certainly their science can be faulted. Why should pre-existing conditions and obesity – things that are linked with as much or more risk than smoking to future medical expenses – be, in essence, sanctioned by the government and smoking penalized? By doing so, Obama says it’s OK to to be fat or drink excessively, but we don’t want you to smoke. Readers of my previous post will recognize that I think the government should have no part either in making those choices for people nor in taking financial responsibility for the consequences.

    How will the ObamaCare nazis enforce this provision?

    DOCTOR: Mr. Jones (a.k.a. “Smoker”), how many packs of cigarettes do you smoke each day?
    SMOKER: I don’t smoke. (cough, cough)

    Nicotine tests, used by insurance companies to detect tobacco use, are typically only positive for 4-10 days after cessation of smoking and this involves another layer of costs. So all one has to do is say I don’t smoke and refrain for a week before the test. Of course, the government can insist that docs do random or profile based testing on their patients – driving another wedge in the gulf that was once the doctor-patient relationship (remember, under the new rules, “your” doctor is no longer working for you, he’s working for whoever is paying his bills).

    Obesity and pre-existing conditions are difficult to hide. Your previous medical record (made fully accessible to government officials by HIPAA, the law that was promoted as protecting your privacy) as well as insurance claims for previous treatments and diagnoses is easily accessible. If you’re fat and try to “hide” it by losing weight for your insurance exam, well, that actually solves the problem rather than hides it.

    The bigger point is: Rights and responsibilities are closely linked. When the government assumes your responsibilities, it will also take your rights. Smoking is just the tip of the iceberg. As the costs of Obamacare continue to mount, government will insist on punishing other behaviors either through taxes/penalties or exclusion. In essence, just as the food industry cannot provide everyone in the US with filet mignon at the cost of ground chuck, the promises of ObamaCare – better access, lower costs and higher quality – could never be met and will never be met.


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