American healthcare in crisis. Part 2: The main driving force behind healthcare cost inflation

Inflation is nearly guaranteed as a consequence of the worldview of modern medicine.  I believe this is true of all modern medicine worldwide, but I will be focusing on how this applies to the US for now.  Our current medical technology is built on the assumption that all illness and disease have physical causes.  We see disease as due to things like bacteria and viruses, physical damage to one’s body, poisons, nutritional deficiencies or genetic defects that are inherited from our parents and foreordained to afflict us.  In the modern medical worldview, our body is viewed as a fantastically complex organic machine and our mind as an epiphenomenon of the function of the firing of neurons in our brain.  With this set of assumptions, it is only natural that the solutions to illness are seen as helping the body rid itself of infection through antibiotics, medications to help restore internal stability (homeostasis) when organ functions are defective, surgery to remove or repair hopelessly diseased or impaired tissues or mechanical devices such as dialysis machines and intravenous feeding catheters and respirators to take the place of non-functioning organs.

These are all medical marvels.  They extend lives that would be otherwise cut short.  They minimize the suffering that results when damaged organ systems cause pain or limit our ability get about, to communicate and to accomplish our important goals.  They also are very powerful in supporting life when severe injury or overwhelming illness would lead to our demise long before our body’s healing resources could be mobilized to repair the damage or threat.  If you have ever had a loved one who has had a heart attack and is in need of a life-saving coronary artery bypass, you know exactly what I mean.  All that matters is saving the life of the one you love.  I am not criticizing our marvelous medical accomplishments here, but I am pointing out a powerful downside to our technology.

Since this approach to illness and disease is totally centered on technology, as this technology advances, costs almost always go up for the wonderful new techniques that replace the old.  As the complexity increases, the costs of more highly trained technicians to run the equipment go up. The training for physicians to order the tests gets longer and their training becomes more costly.  New medications, to be proved safe and effective, are ever more expensive to develop.  To these natural costs, and many others (a comprehensive list would be quite long), we must add the human propensity to be as comfortable as possible, to live as long as possible and to strongly desire anything that seems to promise to help us accomplish these goals.  There will always be a strong demand for new drugs and technologies even if they are only minimal advances over those they are to replace, and this remains so even if the costs involved are dramatically higher (which they often are).

Where I am going with all this is that we are more and more reaching a point of diminishing returns in the setting of rapidly escalating costs.  More and more we are seeing efforts to ration the availability of these dramatically more expensive answers to our medical problems.  This is only natural.  We are to the point where if everyone used the most effective treatments for every illness or medical problem, a huge part of our available wealth would be consumed just keeping as many of us alive and as functional as possible.  We are witnessing an unpleasant mixture of effects.  Healthcare continues to rapidly outstrip inflation in other areas of our economy.  Despite these rapidly increasing expenditures, people are frustrated when they are denied access to the physicians they prefer as well as what they see as the best diagnostic studies and treatments.  In the midst of all this, federal, state and local budgets are straining under the burden of such high healthcare costs that they are eroding the ability to provide other essential government services.  If you take a big view of things and follow the trends, it is indeed a crisis, particularly in the US.  More powerful and more effective rationing will increasingly be resorted to and this will only increase the frustration.

Does it have to be like this?  Are there any other options that can answer our healthcare needs and demands without breaking our household budgets as well as our government budgets?  I believe the answer is yes, but developing the rational behind this answer will be much easier if I first provide an overview of the history of how modern medicine, and for that matter, how modern science has evolved to bring us to where we are to today.  Watch for Part 3: The evolution of modern western healthcare to follow my argument about how we got to where we are now.  This will lead naturally into the possible long term solutions to many our current healthcare dilemmas.

A reminder: if you want to follow the rest of the articles in this series and have not subscribed to an automatic email alert to new articles, you can do so easily to the right on this page.

Chuck

 

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About Chuck Gebhardt

I am a physician specializing in internal medicine. I sub-specialize in nutritional medicine. I am very interested in all areas of healing research, not necessarily limited to traditional medicine topics.
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