health dollarsIn most western countries inflation is under reasonable control. Prices are rising for most consumer goods by 2% or less. In addition to this as technology advances the cost tends to go down. Consider the costs of a mobile phone or computer or car today compared to 20 years ago. I read recently that the cost of flying to Europe from Australia had fallen from 85 weeks work to less than one weeks worth for most people.

One sector has not seen low inflation or reduced costs with better technology is the health sector. In Australia outlays under the Medicare system (which covers doctors) has doubled in a decade. The number of procedures done is growing at triple the rate of population growth.

In the USA spending on prescription medication topped US$300 billion last year and is tipped to be US$400 billion by 2020 – an increase of 22% from 2015.

A good question is, are we any healthier as a consequence of this increased spending?

Former Australian health minister Michael Wooldridge told the Weekend Australian “It’s been set and forget for a long time, people have learned how to game the system”. Whilst health insurers cop most of the flak from the public and politicians, their profits are in decline. The real “winners” are doctors, hospitals and manufacturers (of devices, prostheses and pharmaceuticals).

There are too many issues to go into detail in one blog piece. However some key factors driving the outlays on procedures are the number, which are done without any real need and the costs of prosthetic joints, which can vary five fold.

Guest blogger Dr Skeptic has written a new book called “Surgery; The Ultimate Placebo”. In this he details the many surgical procedures done, which do not actually improve health outcomes. Top of this list is arthroscopic knee surgery for knee pain. Some 35,000 are done each year in Australia. Most are done in capital cities where there is a greater concentration of orthopaedic surgeons.

Pharmaceutical costs are related to both the number of drugs but also the length of time they are taken for. Medications like statins for cholesterol can be life long prescriptions. Anti depressants can end up being taken for many years, as can those for reflux.

There is a view that long-term use of medications has no downside. To be honest even I was surprised to read that long-term use of proton pump inhibitors (PPI’s) could lead to sever kidney damage. This is on top of the impact on good bacteria in the gut and also absorption of some minerals and vitamins.

And for many with reflux, a change in diet or intermittent use of antacids would be just as effective. So there is not just a dollar cost but also a human one as well in this.

Having written extensively about statin medications in the past I will keep it brief here. A new drug, which lowers cholesterol even more than statins, and raises “good” cholesterol levels, when studied on 12,000 people showed NO impact on heart attack rate or mortality. Trials on the drug have been ceased.

Antidepressant use has skyrocketed over the last two decades. Suicide rates in the USA and Australia are not going down. In fact they are increasing!

So we are spending a fortune on drugs, which do not actually do that much to improve health.

An election is looming in Australia. Any suggestion that health spending could be more efficient will be howled down as “cuts” and as the wrong way to go. Translated – doing less unnecessary procedures is somehow wrong. Taking fewer tablets that do not actually help us is wrong.

There is not a bottomless pit of money. When current spending is wasteful and much money is spent on procedures and treatments that do not improve our health, what on earth is wrong with looking to spend money more wisely?

 

Dr Joe Kosterich M.B.B.S is an author, speaker, media presenter and health industry consultant, who wants you to be healthy and get the most out of life. Dr Joe also gives practical, motivational health talks for the general public and organisations where he is known as “An independent doctor who talks about health”.

His latest book “60 minutes to Better Health” is available on Amazon.