Will health care costs ever go down

Health care costs grow at about 6-10% a year in OECD nations. However the human body is limited in the number of things that can go wrong with it. I do not have the chart onhand, but I remember once seeing a chart that discussed growing health care costs, and explaining that most of them are due to the fact that there is more healthcare, more people need it, and more people use it.

For example, more people have type 2 diabetes now than 20 years ago, and of those more are seeking treatment, and there are more treatments to use. So costs go up. So more people are sick, more people who are sick are getting treatment, and the treatments are better. So costs go up.

As society gets older and medical care gets better this trend will continue. However medical productivity should also go up. Especially when we enter the age of robotics, which will depreciate in value rapidly. The Japanese are investing heavily in robotics right now in the hope that in the 2020s when their elderly are retired, they can rely on robotics to perform many health care jobs.

So the trend of spiraling health care costs is going to continue. However much health care spending comes down to a handful of illnesses. Cardiovascular disease, cancer, depression, alzheimers, COPD, arthritis, etc. I believe 75% of medical spending goes to chronic conditions.

As medicine advances we learn ways to prevent and reverse chronic conditions. Type 2 diabetes can now more or less be cured with obesity surgery. The polypill may reduce risk of CVD by 80% or more. Nanotechnology may help us overcome cancer. Osteoarthritis risk can be cut dramatically by getting enough vitamin D and omega 3 fats. So much of our medical spending goes to a handful of diseases, and we are learning more and more about how to prevent, treat and reverse those illnesses.

Like I said earlier, there are only so many things that can go wrong with the body, and a few dozen chronic conditions (excluding trauma) seem to eat up much of our medical spending. Will we reach a point in 50 years when we have (pretty much) cured everything (either knowing how to prevent it, reverse it after it happens, or manage symptoms), and found ways to do it cheaply? There will still be medical problems, but by and large maybe several decades from now we will have conquered pretty much ‘all’ of the major medical problems we have. When that happens, will cost start to go down (as we won’t have more people getting sick each year or requiring better treatment each year) or will medical costs keep rising by 10% a year indefinitely?

Or will medicine start becoming a tool to expand the body’s positive aspects rather than correct for the negative ones? That seems to be happening in psychology, with positive psychology trying to encourage positive human traits (happiness, kindness, peace of mind) rather than correct for negative traits (humiliation, trauma, etc).

I think the latter might be possible, and we may use medicine more and more for brain implants and plastic surgery instead of curing disease.

If these horrible physical problems are getting more and more common, people will begin to die younger. There is always a bright side. They wont use the system as long as they used to.

The current incentives are to develop expensive therapies to ‘manage’ chronic conditions rather than cure them.

Hopefully those incentives will change at some point.

There was an in-depth piece on this on NPR a few weeks ago. Basically the guy was saying that, starting around the 1980s, the medical industry bamboozled the American people into thinking that getting old and dying is a medical emergency that requires lots and lots of treatment. In reality that “treatment” is tantamount to torture and leaves the survivors in 10s or 100s of thousands of dollars in debt, and the “patient” obviously still dies anyway. His description of an elderly person dying of pneumonia 30 years ago vs. today nearly gave me a panic attack. Modern “treatments” are anything but.

He also touched on how the most expensive treatment is almost always sought, regardless of if it’s the most effective.

I wish I remembered the guy’s name, or even which show it was.

Until issues like this are solved, I think who pays (government, or employers, or individuals, or whomever . . . ) is a drop in the bucket. The whole healthcare debate is a red herring, as it’s currently framed.

Agreed. And it was also pointed out to me by several medical types that this is the reason why preventative care doesn’t save the system any money.

Eat well, stay fit, die anyways is true, and that end of life care is what is putting the biggest drain on the system. Live a healthy life and die at age 90 instead of age 60, but you still need that expensive care in your final years.

When the time came, my elderly family members went on Hospice care and signed DNR orders. The doctors gave them enough drugs to be comfortable and happy and then let nature take its course.

On the other hand, it is terrible to see these 95+ people getting CPR and breaking their ribs to keep them alive for another 6 months of pain. When you heart stops at that age, it is your body telling you that it is time to shut down.