"Health care costs" are a constant companion of budget wonks, showing up in every discussion of long-term fiscal policy and discussions of healthcare reform going back decades. But in an Atlantic piece from the end of the year, coauthored with Thom Walsh of the Dartmouth Center for Healthcare Delivery Science, we argue that talking about "costs" ignores our increasing utilization of healthcare services, misrepresenting the real nature of our spending problem and obscuring solutions:
"...the more worrisome reason for rising spending is the quantity of high technology specialty services we undergo. We get more high tech imaging studies, more days in the ICU, more robotic surgeries than we did 40 years ago, or even 14 years ago. Sometimes that high-tech medicine leads to better outcomes, but a lot of the time it does not -- it just means we spend more.
Given this increasing use of high-tech services, it should be easy to see why the "rising healthcare costs" frame is misleading: if we're using more and more services each year, it's hardly reasonable to blame rising costs of production. [...]
The real problem, then, isn't merely that we're spending a larger and larger percentage of our income on healthcare -- it's that we are spending indiscriminately. Yet when healthcare spending rhetorically becomes healthcare costs, it implies that overconsumption of useless, overpriced services is not part of the problem."
Read the full piece at The Atlantic.