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Tag Archives: health care spending

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Looking forward to your daily Double Chocolaty Chip Frappuccino, you see that the calorie count sign says 500 calories. Change your mind? Most studies indicate that knowing a calorie count has little if any impact on purchasing decisions.

Then, you stroll to your local Whole Foods to pick up some fruit juice flavored carbonated drink. Defined by legislators as sugary, the beverage’s price includes a 7% “soda” tax.  The 7% extra does not dissuade you from making your purchase. Researchers have concluded that the threshold is a penny an ounce tax. Any less and people still buy.

Next stop, the doctor’s office where you happily notice that those thick folders of paper records are gone. The practice has fully digitized and now will save all of us money by following the cost saving precepts of the Affordable Health Care Act. Yes? Maybe not. One study from Harvard says that physicians who have fully digitized tend to order more medical tests, thereby increasing costs.

Mandating calorie count information, taxing sugary drinks and digitizing health records… each is supposed to pull down health care spending. But they might not work.

The Economic Lesson

Stanford University health policy expert Victor Fuchs says we need massive policy change to depress health care spending that averages $8000 a person, double Europe’s average. Why so high?

  • Too many specialists.
  • Equipment with excessive “standby capacity.”
  • Inadequate support for the poor who are chronically ill.
  • Drug prices.
  • Physician income.

 

A NY Times bubble interactive for President Obama’s 2013 budget shows perfectly where health care spending is going. Look at the 8.4% increase Medicare and Medicaid.

An Economic Question: Would you support Dr. Fuchs’s solution of a dedicated value added tax that funds universal coverage?

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Perhaps it all began when President Lyndon Johnson called Wilbur Mills, chairman of the House Ways and Means Committee. “Wilbur, I’ve just been looking through the polls here, and I’ve only got a few weaknesses, and the worst of them is that I’m not doing anything for the old folks. I need some help from you.” The result? During 1965 Congress passes Medicare Parts A and B.

Fast forward to 2010 and health care spending that far exceeds what Congress originally projected. Why? Through an excellent 2 week series, The Incidental Economist concisely explains where we spend and “what makes it so expensive”. In a short period of time, you will be able to gain considerable insight.

No, they say, obesity is not the problem. Instead, they look at inpatient and outpatient care, drugs, administration and insurance, investment in health, and health care workers. Then, areas of underspending and red herrings precede their conclusion.

For each component, they provide 2 or 3 paragraphs with basic facts and a summary graph. Discussing inpatient care, they point out that, at the hospital, we actually spend less than other comparable countries. While each day costs more, we stay there for a shorter time period. However, once we are at home, as 41% of all health care outlays, outpatient care propels spending. Moving through big pharma, bureaucracy, and health care workers, some facts are surprising. Interestingly, goods and services that we privately pay for are the focus of their underspending discussion.

At the end of each day’s entry they say, “None of this proves that this money is wasted or fraudulently taken. Nor am I saying that we shouldn’t spend more money than other countries. But this is money that goes above what you’d expect us to spend based on our greater wealth. We should at least be able to account for and explain this increased spending in some way.”

The Economic Lesson

Health care spending is close to 17% of GDP. However, the opportunity cost of health care is far more than dollars. The cost is the missed opportunities to spend some of that money elsewhere, or, instead, to save it.

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A recent “Investor’s Business Daily” article includes a great graph. Downward sloping, the graph represents health care spending by consumers. While aggregate spending skyrockets, individuals are paying less out of pocket.
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=516427
You see where this is going and what we really need to solve.

Law of Downward Sloping Demand: When price decreases, consumers are willing and able to spend more. (And when prices rises, the opposite will ocur.)

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