Why is health care growing steadily more expensive?

Well, there are quite a lot of reasons. But the most obvious to me, the elephant in the room (and I’d don’t mean the GOP elephant) is something never mentioned by politicians. What’s more, we all cheer it on.

I mean the advances in medical science.

Face it. One of the man reasons medicine is costing more and more is simply that doctors can do more and more.

Take my own case. A century ago, I would have died before getting my Ph.D., and the most a doctor could have done was tell me that I had diabetes and it would kill me, painfully, probably within a year if not a few weeks. Oh, my life could have been somewhat extended by a starvation diet, but I wouldn’t have lived long, and I probably would not have stacked up much medical cost.

42 years ago, when I was diagnosed as having diabetes, there was a treatment, insulin. It was cheap—a slaughterhouse byproduct. Hypodermics were glass, and my fingertips were often scalded because those glass syringes had to be taken apart and boiled before each use. Blood sugar tests? Those were carried out in a laboratory, and took several hours. Urine tests were available, but it didn’t take me long to realize that I could have urine sugar so high the tests would scarcely read it while I had every physical symptom of blood sugar so low I almost passed out. The medicine of the time kept me alive, but my diabetes was not exactly well controlled. Probably my eye problems today can be traced in part to this poor control.

Since then I have gladly discarded the glass syringes for disposable plastic, swapped beef-pork insulin for genetically engineered (and much more expensive) human insulin, learned to test my blood sugar with a finger prick, begun using artificial insulins genetically engineered to act faster and slower than human insulin, started using an insulin pump, and added a continuous blood sugar monitor. My diabetes is under far better control, and in fact my blood sugar is usually within the normal range. Thank goodness I have good insurance, because all of this is appallingly expensive.

Diabetes is by no means the only disease to see this kind of improvement in care at an increase in cost. Many cancers that were once fatal or “curable” only by gross mutilation can now be treated with far less invasive surgery, drugs and radiation. More and more conditions that were once a death sentence can be treated, even if few can be really cured.

And as one result, medical costs have skyrocketed. People for whom nothing could be done are now treatable.

Greater possibilities are not the only reason medical costs have climbed, and I’ll touch on some of the others later. But we have to recognize that at least part of the cost increase is simply because doctors can do something other than just tell a patient, “You’re going to die soon.”

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