Why Are Medical Costs So High?

At Cato Unbound, David Cutler, a Harvard public policy professor whose research I used in The Shangri-La Diet, writes:

The most important reason why medical costs increase over time is because we develop new ways of treating patients and provide that care to ever more people.

At least in his essay, Cutler fails to consider an alternative explanation: Medical costs have increased a lot because we have become a lot more sick — more in need of help. Over the last 50 years, obesity has greatly increased. Diabetes has greatly increased. Depression has greatly increased. Depression, including subclinical depression, is now common and has so many bad effects or correlates — less activity, less socializing, less sunlight, poor sleep, less compliance with everything — that its impact on health must be great.

4 Responses to “Why Are Medical Costs So High?”

  1. lasser11 Says:

    “less activity, less socializing, less sunlight, poor sleep, less compliance with everything — that its impact on health must be great”

    In college I had a temp job sorting medical files. It felt like 10 percent of the doctor’s patients gave him 90% of his service. Nothing worked for them. they all were depressed with various aches and pains.

    We all would be better off if Doctors could work up the courage to limit care. The patients would be forced to self remedy (eat healthier, be more active, etc.). but doctors have no incentive to say no. I think Seth mentioned how Jane Jacobs argued that no one would want a privatized, profit seeking police department. Likewise, we shouldn’t have a profit seekers distribute health care like the insurance companies due. But Doctors are much more powerful than insurance companies. They make the decisions. we need to de-profitize the way Doctors make decisions.

  2. seth Says:

    I don’t think that would work very well. Huge amounts of social pressure have not caused everyone to be thin. It’s not that fat people don’t want to be thin; it is that no one has told them how (correctly — there is an endless amount of bad advice available). Absent good advice, it is incredibly difficult. Same with depression. You place too much faith in “self remedy”.

  3. lasser11 Says:

    “It’s not that fat people don’t want to be thin; it is that no one has told them how (correctly — there is an endless amount of bad advice available).”

    I see what your saying.

    but do family doctors really have ground breaking advice on how to lose weight? They tell their patients to burn more calories than intake. basically eat healthier and exercise more. Nutritionist have better advice.

    I guess its the Hayek in me which believes that if we forced ourselves to ignore our current medical system (which is not very effective for the amount of money put into it), some sort of better medical system will spontaneously construct itself.

  4. matt Says:

    Yeah there are a lot of hypochondriacs. My mother is one of them. She eats poorly and does not exercise enough if at all. Thus she is overweight, which contributes to knee problems, type 2 diabetes and depression.

    But at the same time it is surprising to find out that the US government spends more per person on health care than Canada or France, but most americans still have to buy insurance and pay out of pocket expenses.