The Ever Rising Health Care Cost, has to be Cut off Now.
By, Uwe Paschen.
The ever rising Health care cost of the Social Democracies such as Japan, Germany, Sweden and to a certain extend even Canada is putting public health care in serious jeopardy. Last week I took part in a think Tank about the future of Health care. Moreover, how the quality and standards could be maintained and or even improved. This in a day and age where we are faced with a growing elderly population, lower birth rates and new diseases such as Antibiotic resistant Tuberculosis or viruses demanding expensive drugs such as HIV and AIDS.
Why are the costs rising? Several factors come into play here, for one the cost of Medications is going up and the complexity of these medications is nowadays next to none, we need those more complex medications due to an aging population and a longer over all life span wish is causing a higher demand on those high end medications. Further, we have to deal with bacteria growing resistant to antibiotics and with Viruses that no drug or only very complex drugs can fight. This in it self is a major coast factor of our health care system.
The next cost factor and in some cases the largest cost factor would be labour. A Nurse makes an average of $40,000.00 today this income increases with seniority and inflation, a Generalist makes an average of $89,000.00 and a specialist earns today an average of $300,000.00 per annum. Of course, some make less and others make a lot more, why only an overall average is taken into account. Additional labours cost are administrative staff and management as well as cleaning and maintenance staff and Chemist as well as lab technician. Making the labour cost over all the largest single expense of our health care system.
Further Expenses are equipment's such as MRI, X-Ray machines and laboratory equipment. The tag price of an MRI is around 1.2 million Dollar and this machine would be outdate after about 5 to 10 years, there for needing to be amortize with in 5 years in order to stay with the leading edge of technology and remaining competitive as well as providing the best service with the means of the available budget.
All those expenses not forgetting the little things, such as paper clips and disinfecting Alcohol that add up to this mind bugling bill that keeps on growing larger and larger by the day due to simple factors such as inflation and salary raises, benefits and pension plans.
How can this monster be controlled and universal health care be maintained? Many things where tried over the last two decades such as a patient share growing from 10% to now 30% in Japan and Germany implemented to reduce the burden on public health care. Other measures where taken as well, such as reducing staff and saving energy, such as electricity as well as heating and cooling. Even the amount of Alcohol used was reduced in order to save money wish resulted in new problem such as bacteria outbreaks and infections raising the cost again since now we had to counter the new and expensive spread of deadly bacteria.
There are no real solutions other then the obvious once, that are difficult to implement such as Wage cuts by up to 10% for the Nursing staff, up to 40% for the Surgeons and 20 to 30% wage cuts for the administrative staff. This however may result in labour shortages yet unlikely in view of the high unemployment rate that is likely to stay with us for some time. Still it may cause a brain drain with the highly qualified specialist for wish exceptions could be made however those would be unlikely since they would cause social unrest with colleagues and staff.
Further would be the operational life extension of high tech equipment such as MRI, from 5 to 20 Years wish would be pushing it, yet save a bundle. However, this would give the patient second grade health care and no longer the latest technology available on the market place.
The most realistic coast savings would be achieved with deeply ethical and moral changes, such as no longer keeping coma patients on live support for longer then a month. Alternatively, letting severely handicapped and premature new-born babies dye rather then put them through life support, surgery and highly questionable interventions. Each premature new-born not receiving such intervention would save around $700,000.00.
In addition putting a cap on life saving surgeries such as an age limit of 70, meaning no more surgeries can be performed after that age no matter the cause.
For terminally ill patients such as cancer patients allow assisted suicide or also called dignified dying aid. Other such issues came up of course and many questions where raised, both ethical and pragmatical.
What are our priorities, what is most important and what needs to be implemented right away versus what can wait or should be a last resort implementation?
What rights and legislation has to be considered and or changed? Bottom line, how can we make the public aware and accept that we need major changes and some of those will have to be radical.
We will have to face the fact and face reality, making the changes needed and this rather sooner then latter.