Yesterday’s Special Report with Brit Hume had good fun with President-elect Barack Obama’s nominations to head-up health reform. After Fred Barnes suggested that universal health coverage would only increase costs, Charles Krauthammer chimed in with his own unique analysis of Obama’s health care plan.
Using smoking cessation programs as an example, Krauthammer explained that while Obama’s focus on preventive care was “a nice thing, it doesn’t save money”:
The biggest preventative healthcare success in American history is the reduction in smoking. What happens instead of dying young if you smoke, you die older, spending years in a nursing home, and the costs end up higher. I’m not in favor of dying young, but it’s more expensive if you live longer. If you die of a heart attack at 50, that’s awful, but it’s cheap. If you live into your 80’s, you will end up with Alzheimer’s or cancer or a chronic disease that’s expensive.
Krauthammer’s argument is this: if people forego preventive care, they will become sick and die, sparing the country the costs of long-term care. But between diagnosis and death lies treatment of chronic diseases, on which we spend the great majority of our health care dollars.
As the Campaign for Tobacco Free Kids points out, tobacco use adds billions to the national health tab:
– $97 billion: Productivity losses caused by smoking each year.
– $96 billion: Total annual public and private health care expenditures caused by smoking.
– $30.9 billion: Annual Federal and state government smoking-caused Medicaid payments.
– $27.4 billion: Federal government smoking-caused Medicare expenditures each year.
– $4.98 billion: Annual health care expenditures solely from secondhand smoke exposure.
Krauthammer blames rising health care costs on defensive medicine and “trial lawyers,” suggesting that “the way to save money in healthcare, the most immediate and effective, is to eliminate defensive medicine.” “I was a chief resident 30 years ago and a lot of our tests are entirely unnecessary and are a way to prevent lawsuits. The Democrats will never do that because of their dependence on the trial lawyers,” he explained.
Research indicates that “defensive medicine” does affect spending, but only to a point. The Congressional Budget Office concluded that malpractice costs amounted to less than 2 percent of overall health care spending in 2002. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent.
In fact, the larger potential for true reform is in the area of better quality of care and more equitable compensation of those suffering large losses, not reduced health care spending.