Editor’s note: This op-ed is by Don Keelan, a certified public account who lives in Arlington.
So much has been written about health care and as to why we are in such a crisis over its cost. The conclusion most bantered about is that it is all the fault of the insurance companies. And if they weren’t in first place as the culprits, a close second would be the pharmaceutical companies. For what it is worth (and in the absence of over-simplification) I believe the cause lies elsewhere, for a host of reasons.
It is my belief that the spiraling cost of health care had its origin years ago at the time a patient’s chart was permanently removed from the end of the patient’s hospital bed. For generations, the chart had been prominently displayed and allowed all to see the visits made to the patient by the institution’s medical team. It also disclosed what procedures, drugs and vital data where given and or noted.
The bed chart was an integral document for the patients (or their families) to compare with the billing the patients would receive as they made their way to the hospital’s billing office prior to leaving the premises. An adjunct to the chart was the posting of prices for services. When was the last time anyone ever saw a list of prices?
In today’s medical world, a patient doesn’t have a clue as to what services and drugs have been assessed or their costs. To quote Chris Graff from his article in the April 2011 issue of the Vermont Business Journal, “consumers are shielded from the cost of the service.” And for good reason. Such information is no longer the patient’s business: It is between the “provider” and the “third party.”
Thirty years or so ago the providers welcomed having such an arrangement. They were going to be paid in full no matter what the cost, and the consumer was removed from the equation.
I can’t say that the disappearance of the bed chart was the sole reason for the exponential increase in health care cost. Up until a few decades ago the health care industry was not on the radar of the management information technology consulting industry, tort lawyers and equipment manufacturers. Back then cost containment was never an issue for hospitals. The health care field became fertile ground for consultants, as if “black gold was discovered” by the professionals, only to be mined. Today, hundreds of millions of dollars are being spent mining the “mother lode of consulting.”
Then of course there are the consumers of health care — us. I’ve often wondered why politicians are so reluctant to assign to us a larger share of the “blame” for the cost crisis. Is it because they don’t want to offend us and it is much easier to just blame the insurance and pharmaceutical companies?
I can’t help but believe that when we acquired “the remote” for our televisions it was the start of the degeneration of our physical health. We no longer had to get up. This was further exacerbated by the advent of the cell phone. Once again we didn’t have to move.
My index of how healthy we are is not measured by any federal or state statistics that come out every so often but instead by the proliferation of fast food restaurants. This coupled with the length and number of isles in a food store solely devoted to soft drinks, potato chips and nachos are as good as any government data provided on just how healthy or unhealthy the population has become.
Anyone who believes that we will contain health care costs by perpetually lambasting the insurance companies is not in tune with reality. It is no different than what is going on with the sky rocketing cost of fuel oil and gasoline—it is the oil companies who are solely at fault.
Will there ever come a day, when we, the consumer, own up to the fact that we also have been a factor, indeed a large factor for the cost crises in health care (and energy)? For some reason I don’t believe we will. So let’s ignore it, revamp the whole healthcare system by having government be in charge. Significant decreases in healthcare costs will surely follow …
