This is an extremely long article documenting our 'road to hell' in health care. Like all other creations based on promises by politicians to gullible voters, both long dead now, this monster will consume us all until it implodes under its own weight.
This commentary was published in the peer-reviewed Journal
of American Physicians and Surgeons Volume 20, Number 3, Pages 83-89, Fall 2015.
This year marks the 50th anniversary
of Public Law 89-97, the Social Security Amendments of 1965 that created
Medicare and Medicaid. I graduated from medical school that year.
Over
the last 50 years the federal government has become increasingly involved in
medicine, functioning both as a third-party payer and patron of biomedical
research and clinical trials. [1] And starting 25 years ago, modern medicine
has come to adopt a new type of probabilistic medical thinking named
“evidence-based medicine.” [2]
Healthcare
spending in 1960 was 5.2 percent of GDP, $143 per person—equivalent to $1,125
in 2013 dollars. Lawmakers projected that Medicare would cost $12 billion a year by
1990. It cost $98 billion that year. In
2013, the annual cost of this healthcare program for people 65 years of age or
older, and people under age 65 who are disabled or have end-stage renal
disease, was $585.7 billion (and growing at a 3.6 to 4.1 percent rate
annually). Medicaid is not far behind. The annual cost of this joint
federal-state program, established to finance medical care for the poor, was
$449.4 billion (and growing at a 6 percent annual rate).
The
total amount spent for healthcare in the U.S. in 2013 was $2,900 billion, 17.4
percent of GDP, which amounts to $9,255 per person. This is a nearly nine-fold increase, adjusted for
inflation, compared with what Americans spent on medical care before enactment
of Medicare and Medicaid. (It is a 65-fold increase, $9,255/$143, in nominal
dollars.)
