First, let's get a little historical perspective on American health care. To do that, let's turn to the American civil war era. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause terrible results. The majority of the deaths on both sides of this war were not the result of actual combat but to what happened following a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail's pace in most instances causing severe delays in treatment of the wounded. Secondly, most wounds were subjected to wound related surgeries and amputations and this often led to massive infection. So you might survive a struggle wound only to die at the hands of medical care providers whose good intentioned interventions were often quite lethal. High death tolls can be ascribed to everyday sicknesses and diseases in an occasion when no antibiotics existed. Altogether something such as 600,000 deaths occurred from all causes, over 2% of the U.S. population during the time!
Let's skip to the first half the 20th century for many additional perspective and to create us around more contemporary times. After the civil war there were steady improvements in American medicine in the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But also for the absolute most part the best that doctors could offer their patients was a "wait and see" approach. Medicine could handle bone fractures and perform risky surgeries and the like (now increasingly practiced in sterile surgical environments) but medicines were not yet available to deal with serious illnesses. Many deaths remained the result of untreatable conditions such as for instance tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly conscious of heart and vascular conditions, and cancer but they had next to nothing with which to take care of these conditions.
This very basic knowledge of American medical history helps us to understand that until quite recently (around the 1950's) we had almost no technologies with which to take care of serious or even minor ailments. Nothing to take care of you with ensures that visits to the doctor whenever were relegated to emergencies so because scenario costs were obviously minuscule. Another factor that has changed into a key driver of today's healthcare costs is that medical treatments that have been provided were paid for out-of-pocket. There is no medical insurance and certainly not medical insurance paid by somebody else as an employer. Costs were the responsibility of the in-patient and perhaps a few charities that among other activities supported charity hospitals for the poor and destitute.
What does healthcare insurance have regarding healthcare costs? Its effect on healthcare costs is enormous. When medical insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight there is a good pool of money readily available for health care. Money, as a result of the accessibility to billions of dollars from medical insurance pools, encouraged an innovative America to increase medical research efforts. As more and more Americans became insured not just through private, employer sponsored medical insurance but through increased government funding that created Medicare, Medicaid and expanded veteran healthcare benefits, finding a cure for just about anything is becoming very lucrative. This really is also the principal reason for the vast variety of treatments we have available today. I do not wish to convey that this can be a bad thing. Think of the tens of countless lives which were saved, extended and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on healthcare costs are inevitable. Doctor's offer and the majority of us demand and get access to the most recent available healthcare technology, pharmaceuticals and surgical interventions. So there is more healthcare to pay our money on and until very recently the majority of us were insured and the expense were largely included in a third-party (government, employers). This is actually the "perfect storm" for higher and higher healthcare costs and by and large, the storm is intensifying.
At this point, let's turn to an integral question. Is the current trajectory of U.S. healthcare spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being allocated to healthcare? What're the other industrialized countries spending on healthcare and could it be even near to these numbers? Add politics and an election year and the complete issue gets badly muddled and misrepresented.
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