We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
We have often said that American medical costs are a measure of our prosperity, our inventiveness, and expecially our remarkable pharmaceutical and biotech industries which are the envy of the world (and upon which the rest of the world depends).
Without advocating anything I've heard of in the way of socializing health care costs, let alone health care itself, the fact is that health care bills for catastrophic incidents -- serious injury, serious illness, terminal care -- are high and they can devastate a family's finances. The answer in any other industry would be competition to increase efficiency, then accept the increased cost as necessary to obtain the benefits of longer life or decreased pain or improved function.
Competition isn't much of a reality in healthcare. If you have a family doctor and you need a specialist's services, your family doctor is likely to recommend someone and you will almost certainly go there. In a large community, there may be some level of price competition among facilities but not much -- insurance fee schedules tend to eliminate it. In a small community, there may only be one significant clinic or hospital. Without serious competition, health care efficiency has very little drive.
Proof? Cosmetic care and laser vision correction. Both are primarily self pay and both have reduced their costs over the years. Does this apply across the medical industry? Maybe not. The development of effective chemotherapy is costly the medications themselves are costly to produce, and the training required to manage them is also costly. People staring down a life-threatening situation will go to great lengths and that seems only right.
You can't expect a society to control costs when there's such a huge disconnect between the payor and the recipient.
Health costs make us get this irrational for two reasons, I think. (1) The idea of anyone's not being able to afford health care punches all our buttons about fear of illness, pain, and death. But so does the idea of not being able to afford food or shelter, so here's the reason we find it especially difficult to cope when it comes to medicine:
(2) Health care isn't something everyone needs in a fairly predictable stream every day for the rest of his life. We need a little from time to time, and then it's possibly that suddenly we'll need a ton of it, in the worst way, just when we're most severely distracted from the ability to earn and save up for it.
That risk of suddenly spiking cost really can be handled only by some kind of pooling of risk. Insurance is the obvious answer, but we've twisted our insurance system into pretzels, mostly by relying unduly on employer-provided or government-provided insurance. Now we think insurance coverage should grow on trees just as we had started to conclude that medical care should grow on trees. Magical thinking never works.