Monday, October 5, 2009

What is and isn't included in health care costs?

Much has been made about the fact that Americans on average spend far more for health care than citizens of other countries and that we still lag those countries in measures of health care outcomes. But there are a lot of questions about what should and should not be counted as health care. One example is cosmetic surgery. This is not covered by health insurance, but it is included in calculations of health care costs. We are paying doctors for breast implants instead of providing health care. Mental Health care costs are also included, as are dental care and elective procedures such as in vitro fertilization. These items are legitimate costs, but their inclusion skews the picture of how much we spend on health care relative to other countries.
Another cost is long-term care. I do not mean to diminish it's importance, but costs could be dramatically reduced if multi-generational households were the norm as they are in many other countries. If I pay $20,000 a year to put my mom in a nursing home, then it is a health care cost. If I give up $20,000 in possible earnings to take care of my mom, then it is not treated as a health care cost. These two situations should be treated the same in order to properly compare health care costs.
American doctors are also paid a lot more than their foreign counterparts. One reason for this is the time and money doctors must devote to their education. In many other countries, medical training is provided by the government, or at least subsidized to a greater extent. in the US the cost of education is indirectly included in health care costs through the higher payments to doctors. In other coutries, these costs are not included in health care costs because they are costs of education.
It may be true that we spend more on health care, but the numbers don't tell the whole story.

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