The Real Story Of Health Care Costs in the U.S.

Truly affordable, and possibly mandated government-sponsored or government-controlled health care insurance in this country is at the forefront of all the political campaigns this year. Both sides of the aisle believe they have the answers. However, none (and, I mean "none") of them addresses the real reason that health care is so unaffordable for so many in this country.

The answer is fairly simple. It is malpractice lawsuits.

In their defense, the attorneys who are involved in malpractice litigation will point to the fact the dollars being awarded as a result of their lawsuits pales in comparison to the aggregate annual cost increases being charged by the health insurance companies and the medical profession. And, that is true.

However, to see the "true" impact of lawsuits on the medical system in this country, you need only look at "9/11" and the loss of the World Trade Center buildings as a parallel. The replacement cost of those buildings, two planes, and the remaining lifetime salary potential of those killed in that tragedy, are a mere fraction of the trillions of dollars that Federal, State, and local governments and corporations are now (and probably will be forever) spending for increased "security measures" to prevent that event from ever happening again.

The same is true in health care. Today, doctors have a fear of lawsuits. They don't want to be sued because their individual rates will increase. As a result, patients are subjected to more tests than ever to make sure that their reason for seeing a doctor isn't something "more" than just a cold, a sore throat, body ache, etc. In the same way that we, as a country, are trying to prevent another "9/11" with extensive and very costly security measures, doctors are taking extraordinary steps to insure they don't misdiagnose and, ultimately, get sued. That's why many doctors are increasingly using "specialists" as a form of second opinion to insure that they, alone, don't make an erroneous decision on what ails you. This is "CYA" to "nth" degree! All these tests and referrals to specialists are driving costs through the roof. And, while insurance companies and Medicare can control the costs of the "individual tests" and office visits; they are unable to step in to control the frequency and breadth of either. That's why costs are going up so fast.

In addition, we know more than we did years ago. For example, we know that high cholesterol can lead to a stroke or heart disease. Millions of Americans who can't control their cholesterol are put on "statins" to control it through medication. Once you are put on one of these "statin" drugs, you have now committed yourself to an expensive blood test every 90 days to insure that your liver function is not impaired. And, it's the insurance companies (and, ultimately us) who pay for all those tests. Even though the incidence of liver failure as a result of taking a "statin" drug is relatively low, the doctors are "not" going to take the risk that you have an impaired liver function and wind up suing them. So, as a result, 2 or 3 thousand dollars a year will be expended in medical costs and the cost of the medications, themselves, to insure you, primarily, don't have a stroke or heart attack (which could also result in a lawsuit against a doctor), and, secondarily, don't have liver disease which could result in future litigation.

And, here's another example. One of the reasons that we have so few influenza vaccine manufactures in this country is because 90% of them were driven out of that business by lawsuits. Every drug manufacturer builds a certain amount of cost into every drug they develop and market to cover the risk potential of lawsuits. And, that's why so many drugs can cost more than the cost of dinner each day. Those manufacturers know that "no" drug is 100% safe. There are always side effects and potential long term consequences. However, the legal profession sues on the basis that there be no risk at all!

If we, as country, want to get serious about making health insurance broadly available to everyone, we have to start with tort reform in the medical care arena. In many countries, that have socialized medicine, the ability to sue is severely limited because, to do so, would be to sue the government. Doctors are just employees of the State. There's no juries awarding millions and, subsequently, a third of that award being given to an attorney as a big fat paycheck. Nor are there any awards for pain and suffering or any premium imposed as "punishment". Generally, a governmental panel will decide if you are entitled to any compensation; and, if so, it is usually in the simple terms of wages being lost. In some countries, the panel can refer a case to the courts. But, it's their call and "not" some attorney's. The punishment of failing doctors is left up to a governmental review system and "not" done in the court system.