U.S. health care spending last year totaled $2.68 trillion. That’s 10 times what health care cost in 1980 and two-and-a-half times per capita more than most developed nations in the world. Speaking to the American College of Physicians, Ezekiel Emanuel, M.D., well-known health care policy consultant, blamed the fee-for-service payment system for the high cost of medical services in this country. He said doctors were the only ones who could change that. He couldn’t be more wrong. It’s not the fee-for-service payment model that’s the problem and doctors aren’t the only ones who can change the system.
Just a few days before Dr. Emanuel’s address, Medicare officials announced they would consider covering gender change surgery for people afflicted with what is called gender identity disorder. Not only is this procedure extremely expensive and not always successful, it calls for a lifetime of treatments and hormone therapy necessary to maintain the desired gender effect. Medicare coverage of this treatment would not just affect those 65 and over but all of us because whatever Medicare covers becomes the basis for all other health care insurance coverage. We all would end up paying extra for it.
Now it happens that this particular matter was at least temporarily tabled by the decision makers at Medicare but the push to add still more benefits to everyone’s health insurance continues unabated. AB 460 is under consideration by the California legislature right now. It’s a bill requiring all health insurance to include infertility treatments for gay couples. If a couple cannot become pregnant after a year of co-habitation (I’m not kidding here) their health insurance would provide for egg donations and surrogates for gay male couples and sperm donations and artificial insemination for lesbian couples.
Because government directly provides Medicare and Medicaid and regulates all other health insurance, special interest groups are free to pressure elected officials and un-elected bureaucrats to support their pet projects with your tax and health insurance dollars. This is a big reason the cost of health care has gotten out of hand and it’s nothing physicians acting as physicians can do much about.
Reader comments accompanying the Medicare gender-change announcement expressed concern for the people who are gender-challenged and felt these people should be helped. I’m sure many likewise feel compassion for family-aspiring gay couples. Rather than demanding that everyone else should pay for rectifying these problems, these special interest groups should spend their energy raising money amongst themselves for these special causes.
Most of us would not willingly pay extra for sex change surgery or infertility treatments for gay couples or a host of other things that have nothing to do with us. Unfortunately, the Affordable Care Act (ACA) and the un-elected bureaucrats of Health and Human Services (HHS) have begun, in the name of health reform, to add even more benefits we’ll have to pay for. Dr. Emanuel’s fellow doctors can’t do much about this either.
Our next blog will look at the other reason health care costs in our country are so high; and it’s not fee-for-service.