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Who will pay for health care?
© St. Petersburg Times WASHINGTON -- If prescription drug expenditures keep rising at their current pace, can our health care system withstand the burden? The nation's expenditures for medicine rose 17 percent last year, according to a report issued last week. That means spending on drugs has doubled over the past four years. Only one-third of the increase can be attributed to higher drug prices. Other causes include: Our increasing reliance on prescription drugs to treat illnesses that previously were treated with over-the-counter medicines or went untreated. Before Vioxx, for example, arthritis sufferers relied mostly on aspirin. The substitution rate of generics for brand-name drugs is lower than it ought to be. It seems many Americans have a brand-name fetish, which the drug manufacturers encourage with their intensive consumer advertising. Drug companies also have been known to resort to guerrilla tactics to keep generics off the market. We are guilty of overusing prescription drugs. Many doctors are known to write prescriptions just to satisfy a patient's anxiety. The overuse of antibiotics has even rendered some of them useless. Last time I took my teenage daughter to the dermatologist, he wrote her nine prescriptions to treat a relatively minor case of acne. Some economists predict the development of miracle drugs will eventually reduce other health care expenditures. The theory is that drugs will prevent surgery and hospitalization. But so far, there is little evidence to substantiate these predictions. Some drug treatments are as expensive as surgery. And it seems that treatment with drugs is only a precursor to surgery and then to more treatment with drugs. If patients paid for their own health care, the dramatic increase in expenditures for prescription drugs would certainly be viewed as a national crisis. But many people don't care because they are not footing the bill, at least not directly. But we are fast approaching the limit to how much our employers and the government can pay for our health care. Why do you think Congress has not yet enacted a prescription drug benefit for seniors? It has nothing to do with a lack of political will; both Republicans and Democrats would love to do it. The answer: It's too expensive. The higher drug spending rises, the harder it becomes for the government to pay. And why are so many employers searching for new ways to unload the burden of covering their employees' health care costs? Because health care costs are undermining the profitability of some of the nation's most successful corporations. In 1994, President Clinton was right when he warned us that the health care system was heading for a crisis. Even though Congress rejected Clinton's solution, the health care industry postponed the day of reckoning by embracing managed care. Now, we are told, there are no new savings to be realized through managed care and the crisis is once again looming. There are no quick fixes available. In fact, come to think of it, there are no easy long-term fixes available, either. We are not inclined to create a nationalized system of health care because taxpayers would balk. We are not about to put a bigger burden on employers because it would slow economic growth. At the same time, we don't believe that patients should have to pay for their care. So who's left to pay? It seems we have developed a super-duper health care system on the crazy notion that there will always be someone else to pay for it. -- Sara Fritz can be reached by e-mail at fritz@sptimes.com, and by telephone at 202-463-0576.
 © 2006 • All Rights Reserved • Tampa Bay Times
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Times columns today Howard Troxler Jan Glidewell Gary Shelton Sara Fritz |
