physasst,
Same argument has been made for decades, actually -- look at healthcare inflation during the 60's (following the hallowed MC inception), 70's, and 80's -- when it was often low double digits. 6% does not sound so bad when viewed in historical context and considering the demographic shifts in the population.
http://hadm.sph.sc.edu/COURSES/Econ/Classes/nhe00/
So everyone wants to pay less for healthcare -- we all get that. Here's another keenly astute observation -- everyone wants to pay less for everything, by the way. Want cheaper healthcare? Make it cheaper to provide, accept lesser treatments (and probably lesser providers), and everything else that goes along with it. If the society at large agrees to these terms, then so be it -- but to want all and have someone else pay for it is not a sustainable course either.
... and this risk/cost transferrance is unacceptable no matter how you look at it. The discussions have gotten to the point where I hope physicians unionize and throw some weight behind their side of the discussion.
But it's not simply the increase per annum. It's the total of increases over time. As Zeke points out in his book, today, medicare and medicaid consume 22.9% of all federal dollars, but by 2017, it will be 33%. And at current spending, Medicaid and Medicare together will consume ALL federal tax income at current rates by the year 2050, by 2080, Medicare alone will consume more than the sum total of all federal tax dollars levied. And this is likely inaccurate, as these numbers were calculated by the CBO using a predicted increase in medical spending of only 4.1%, while history has shown a higher annual increase on average.
Also, if you want to look historically, in 1966, the first year of Medicare, only 19 million Americans were covered, at a cost of 3.3 billion, or as a more accurate economic measurement, only 0.4% of GDP. Conversely, in 2006, we provided care to 43 million Americans for about 400 billion, or approximately 3.1% of GDP, and in 2030, 20% of the population, or 79 million people will be on Medicare rolls, and consume 6.5% of GDP, or 1 of every 15 dollars in taxes.
If the economy was elastic enough to continually expand, and our GDP would grow at rates similar to healthcare, we wouldn't even need to have this discussion. But it is not, in fact we are still in a period of contractility. And, when it is consuming an ever larger percentage of GDP every year, and is starting to threaten businesses (see my small business thread), and the very stability of long term fiscal growth, and federal budgetary management, then some solutions need to be found.
As I said, without learning MORE about Prometheus, I would not necessarily be crazy about it, but I think as a "concept" it might be a move in the right direction. I would need a lot more information to completely support it however. But as a general concept, it fits with my promotion of the "Pay for Value" concept that is one of our cornerstones at the Health Policy Center.
Thanks for the link btw. Good read.
