The Ever Rising Health Care Cost, has to be Cut off Now.

by Uwe Paschen | March 5, 2009 at 05:32 am

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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.

http://www.mckinseyquarterly.com/Public_Sector/Government_Regulation/Addressing_Japans_health-care_cost_challenge_2144

http://www.npr.org/templates/story/story.php?storyId=89626309

http://ideas.repec.org/a/eee/hepoli/v88y2008i1p100-109.html

http://sciencelinks.jp/j-east/article/200702/000020070206A0892643.php

http://connection.ebscohost.com/content/article/1031780020.html;jsessionid=F6D070C81A42F4C9440B0CA6C8458C37.ehctc1

http://www.sibson.com/publications-and-resources/perspectives/volume_14_issue_1/total_health.cfm

http://www.un.org/womenwatch/daw/csw/cost.htm

http://www.un.org/esa/policy/policybriefs/policybrief2.pdf

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Ra (not verified)

at 15:36 on March 5th, 2009

" 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."
well that's just plain wrong, you put savings on costs above the meaning of life. Last year a coma patient woke after nearly 20 years. One month is a very short time for a coma patient.all children born are born equal and should receive whatever treatment they need.

Uwe Paschen

at 19:08 on March 5th, 2009

That is why the question, where do we start and where do we stop? What are the priorities and so on. No one wants to die nor lose a loved one even less a child. Yet, we need to make choices, since we can no longer finance this system. Ignoring the problem will not make it go away. It has to be dealt with and solutions have to be worked out as well as compromises will have to be made.

This was just a think tank dealing with all issues and aspects of the problem. Why it is called a think tank. And I only scratched the surface here in this post.

Amy Judd

at 14:21 on March 5th, 2009

I think that it should be cut off and capped but companies are making too much money from it - that's the problem. It's so sad to think about all the people that can't afford health care.

Rhonda J Mangus

at 18:23 on March 5th, 2009

Thanks for an interesting post and comment thread, Paschen!

Mary Richard

at 07:21 on March 5th, 2009

I donno, Paschen, what if it were your newborn, or your mother, needing surgery? Things have to be monitored, but not quite that stringently, I think.

Uwe Paschen

at 17:26 on March 5th, 2009

You really need to learn to read and drop your agenda. You have been commenting in most of my post for month now and under several not verified names and that is fine, I do appreciate constructive critics, but that is not what you do for the most part any way.

This was a think tank and those questions need anthers. As a society we have to deal with those issues and make choices and find solutions. Why the post so each and every one may be able to think about it and have they say and input as well as suggest solutions or alternative, since the next think tank is coming up in three month and eventually will be legislated in another two years.

I am not sure what my though are on all this my self for now. However I know we have to deal with it and make choices. Problems do not go away by ignoring them nor by simply screaming wolf when people take their democratic duty serious and act responsible wish I can not see in most of your comments.

Uwe Paschen

at 21:01 on March 5th, 2009

It is an editorial, why it is marked Opinion and had you read it you would know that.

It is one thing to comment and another to be disgraceful, for lack of better words.

gerrypopplestone

at 23:09 on March 5th, 2009

I don't know a great deal about the US system (except that the insurers seem to profit) but JamesMMM suggestion sounds sensible. But I think people who pay for insurance to ensure they get premium treatment (whatever that is) would be angry about it.

Hermes (not verified)

at 16:16 on March 5th, 2009

your view of health care is very simplistic and full of holes, I could spend all day on it but I'll just give two examples:-

I start work at 20-years and remain in work until I reach 70-years. In those 50 years I have paid my contribution to health care, but I was healthy and during that time I never required any health care. At 70-years I require a major operation but in your view I should not be entitled.

I have a dear friend who was born six months premature and required hospital treatment for the first year of her life. Her first year was spent in hospital but since then she hasn't required any health care. She is now almost 60-years and I think she'll live for quite some more, but according to you she would never have made it pass the first month?

Uwe Paschen

at 17:32 on March 5th, 2009

It is always amazing how the not verified are the most arrogant and ignorant.

Have you even read the post? If this Post is stupid as you claim, then I am not sure what your comment here is. This was a think tank and the questions raised here where broth up and are legitimate.

As a society we need to anther those questions and deal with them. The Netherlands did and still do they have made some drastic changes, so did Australia and Germany as well as France. Other nations are doing it and Japan is doing the same thing now.

You claim health care to be a human right and that is fine, Ideally it should be so. However should housing and food as well as water not be a human right as well, and if so, even more fundamental right?

How come we have so many home less and hungry people, even some that have no access to clean water and this in industrial societies not in the so called third world?

Unfortunately we have, still today and in spite of education and information to many people that are ignorant and shows to remain that way.

gerrypopplestone

at 19:05 on March 5th, 2009

An important post. Glad you did it, Paschen. ALTHOUGH I CAN'T AGREE ABOUT THE OVER 70S not getting surgery. I have a friend who is a child specialist surgeon and he thinks the time/energy we spend trying to save children whose quality of life will be poor is not a good use of scarce resources. In the UK, we have NICE (Nat Inst if comparative efficiency?) to decide which drugs to permit and which are too expensive. Its a move in the right direction. One you you omit is RESPONSIBILITY for personal health. Ive just had breakfast with two westerners who are my age but seriously overweight. Yet they kind of avoid the issue completely. My local hospital in London gets crowded every weekend with traffic crash victims that are the result of drink. We campaign about thjis in the UK and the figures ARE improving, but is the state responsible for people's irresponsible behaviour? Difficult!

gerrypopplestone

at 19:08 on March 5th, 2009

We may think that drug companies get too much money but heir risk assessments of the investments show that they often fail in their research. If the research does not pay off, hen they lose money. They have improved a lot in their willingness to allow Indian companies to copy their drugs and sell cheaply in India.

djermano

at 06:07 on March 9th, 2009

http://my.nowpublic.com/health/china-and-americas-health-care-debate.....

I am getting a lot of flack for writing an article I deem to be true, but people are jumping on me that its an opinion....What gives here? You know there is a problem....and the solution is looking at Americans right in the face......No need to blush....it's China and its medical ways.

The profit machine can't count any higher so its all down hill here from now on. Get use to it....Realize America hasn't reached a billion a people yet, but when it does......you are going to be looking to Chinese history in how to solve issues, not American history...

Rev. Jermano....

Uwe Paschen

at 19:55 on March 5th, 2009

Thank you for the comments Gerry, You are correct many are responsible for their own bad health due to being obese or smoking and drinking alcohol and so on...

Why I think that by taxing those things such as Alcohol and pollutants we can make two things work well, on one hand we can finance our health care system with out having to make drastic rules such as no surgery after 70 or 80 or what ever the limit since we would not need to put a limit into place and still keep public health care accessible to all.

Further we would force out bad habits with out having to police them wish cost a lot since we do not out law them but rather put a tax on them and discourage their use by making it expensive.

I know many hate taxes and so do I, however taxes can be a great tool as well if used properly.

James MMMM (not verified)

at 20:20 on March 5th, 2009

Hi guys I couldn't read all the posts but I have a solution to the USA, try to get this around--Obama says he wants all interested parties to suggest solutions--to here goes:

Right now, the US is in the middle of a worsening healthcare crisis, (and it is sure to get even worse if we change from ICD-9 to ICD10) and the government program for the elderly and disabled (Medicare) is functioning but costs too much (labor/administration+) The managed care plans have mostly failed, and it costs them more to cover patients than Medicare.

Since the 'private' health insurance industry would cry foul at the mere mention of a decrease in funding, we cannot cut them off completely. But if every person in the US came under Medicare, we would save lots of money. And since Medicare does not pay 100%, the 'private' carriers would be able to work the market for the plans which would pay the part of the bill that medicare did not pay!

This could be combined with a tax deduction/credit for medical expenses that ended up being paid out-of-pocket!

lets here it for saving the American Healthcare system!

Jamesm

Hermes (not verified)

at 20:55 on March 5th, 2009

you flagged your post with "opinion" so don't that indicate this is your opinion? I have commented on several posts recently including yours. You make a post, people are free to read them, recommend them and add comment if they want, that's the structure of NP.

duo

at 07:24 on March 6th, 2009

I cannot imagine a national healthcare system being fair to low and middle income people. It will probably soon be filled with term limitations that only apply to those with limited revenue, because people with substantial means don't have to worry about restrictions on healthcare expenses. I envision lots of dead and dying people with remedies available but out of their reach. That is certainly not the intention of the people putting forth this plan, but I believe it would be the eventual outcome.

Uwe Paschen

at 17:25 on March 5th, 2009

It may be Amy, I am not sure my self at this point. Why I raised the issue.

It is sad in deed that many can not afford health care while other manage to abuse the systems in place.

Uwe Paschen

at 07:53 on March 6th, 2009

duo, I appreciate the input, one question though, are you relating to the US or the Social Democracies that do already have a public health care plan and try to maintain it?

asherr60

at 01:18 on March 15th, 2009

Paschen,

Where prescriptions researched and formulated in America are concerned; our Congress and Senate passed legislation some time ago that authorizes Pharmaceutical companies to charge Americans more for Rx’s than they charge of their foreign markets in order that we (the American people) shall bear the greater part of their research and development costs. Most Americans feel jaded by this legislation. It is because of this slanted special interest giving’s-in that our legislative community is bent on banning Americans from buying the same meds from Canada where they are significantly cheaper or to purchase them from Mexico where most meds are available over-the-counter and without a prescription.

The American system of healthcare is technologically retarded. That is to say, our system has never kept up with sound and secure technological advances that are certain to lower our costs of healthcare majorly. Because our system lacks technological coordination, patients often as required to have duplicated x-rays taken, lab tests retaken unnecessarily, ineffective treatments rendered without the ease of colleague collaboration, and so on. Records keepings presently are costly, wasteful, and environmentally destructive. Paper waste is insurmountable as well as the inability to access records technologically that is raising the cost of healthcare as well; not to mention the labor hours attributed to these huge undertakings. President Obama is bent on reinventing <?xml:namespace prefix = st1 />America’s healthcare system technologically. You may not be aware of this fact, but in good times when America’s big three automakers are doing well healthcare costs for their employees are approximately $1500.00 of the selling price of every car sold here and around the world. Wow, said I when first I heard this.

Paschen, I don’t believe the answers lay within restricting patient care and surgeries to those over any given age nor making it legal to euthanize (although I think euthanizing should be legalized for humanitarian reasons) and other drastic steps you illustrate in your piece.

In an effort not to sound too conservative I feel restricting medical incomes will dissuade quality personnel from entering the medical field and slowly deteriorate the human quality of it drastically. Moreover, I believe that answers lay more in legal solutions such as putting caps on malpractice suits and exposing frivolous and fraudulent attempts prudently.

Other relevant areas of concern are what manufacturers charge for things like mobility scooters and the like and believe it or not; here in America Medicare and Medicaid actually pay as much as $5000.00 + for a single mobility scooter. Over-the-counter items also rank high in consumer appraisals of things that stretch fixed incomes. Our commercial system builds in the high costs of advertising within these medications, both prescribed and over-the-counter, huge percentages of the retail prices charged.

There are so many more avenues for savings that can be advantaged, I am sure. Many, hopefully, will be made more transparent so that these too can be made more economically efficient.

Thanks for your informative post.