Code Red: Two Economists Examine the U.S. Healthcare System

February 10, 2010

The Audacity of Denying Hope

Filed under: Health insurance,Health Reform,Health spending,International Comparisons — David Dranove and Craig Garthwaite (from Oct 11, 2013) @ 9:46 am

A very close acquaintance was recently diagnosed with a life threatening condition.  As he receives treatment, our entire healthcare system is being laid bare before me.  If there have been any surprises, it is the way that the strengths and problems of the system are magnified when academic concerns becomes personal.

Our healthcare system has so many strengths.  My friend has access to some of the best specialists in the world; the same doctors treat patients from across the socioeconomic spectrum.  He has received a battery of tests that helped his doctors refine the diagnosis and even change the treatment regimen.  I wonder if he would have been so fortunate if he lived abroad.  And he is now receiving a regimen of drugs that cost a fortune to develop but arguably would not have reached the market if the drug maker could not charge high prices in the U.S.  In short, my friend is getting the best care money can buy.

Yet at the end of the day, my friend’s prognosis is not good.  Most of the spending is buying hope, not an actual cure. Some would decry this as wasteful spending.  But until the doctors tell my friend “there is nothing more we can do,” his future remains unwritten.  For the next few months, hope is all that he and his family have.  I could hear it in their words and see it in their eyes.

With hope for his health has come aggravation about finances.   Here are just some of the comments my friend has twittered:

“A refill of a painkiller was denied, because I shouldn’t have used so many so quickly. [The pain had its   own schedule].”

“The literal headaches from awaiting test approvals, outpatient, inpatient, overnight, justification to keep overnight, all of it is nauseating.”

“The endless statements from (my providers) and (my insurer) are impenetrable.”

“I have had my hands full with this crap.”

To any who want to blow up the U.S. healthcare system, this is a familiar litany of complaints.  Yet within a week, things were squared away with insurance and my friend and his family have refocused their energy on survival.  Aggravating, yes.  But reason enough for the government to take over the system?  I don’t think so.   At best, my friend would have been spared some administrative nightmares. That would have been most welcome, especially at this stressful time.  But what about hope?  Would he have had the same access to all of these tests, procedures, and drugs?  I just don’t know.  But I suspect the worst.

Everyone wants to cut healthcare spending and my friend is a poster child for the extravagance of the U.S. system.  But don’t tell me that the money saved by skimping on my friend’s care could be better spent on prevention or covering the uninsured.  Health spending is not a zero sum game.  Our economy survived even as health spending grew to 17% of GDP; we can stand to spend even more on health and less on other stuff. (Watching the Super Bowl commercials, I was struck by how much crap we purchase even during a recession.)  I am not saying that we should spend money on health services that have no value, that offer no hope.  Perhaps some of the tests and procedures were excessive and perhaps we can one day figure out a system that cuts the fat without cutting the bone.  But we should tread cautiously.

We all cling to life, hoping that the next day will hold something special.  Who would deny my dear friend his sliver of hope?

1 Comment

  1. Prof. Dranove,

    I found your post extremely relevant to me. Right before my second year at Kellogg, I suffered a major stroke. The care I received was world-class. I survived, recovered completely, and then was denied private health insurance after graduation because of pre-existing condition. I experienced the best and worst of our system personally. It’s a mess and I wouldn’t know where to start trying to fix it.

    But while I may not be able to fix healthcare in America, maybe I can help your friend.

    As a response of my stroke, Scott Orn (Kellogg 07) and I created a network of patient communities to help people who are dealing with life-threatening or chronic medical conditions. ( I could perhaps put him in touch with others who are going through the same situation.

    Ben Munoz
    Kellogg ’07

    Comment by Ben Munoz — February 16, 2010 @ 10:01 am

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