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The Real Spending Problem

By Dr. Nilesh Kalyanaraman

Unless you cut your cable, disabled your Wi-fi, and burned your newspapers, you‘ve have had the sorry experience of watching our politicians demagogue on our national debt. Yes, we have a lot of debt but once our economy starts growing again, our nation’s financial shape should look a lot better in the short-term. But our long-term problem won’t be solved by unless we tackle just one thing: health care spending.

Our real crisis, as I’ve written in the past, is that health care costs are expected to rise every year for as far out as we can project. A new study projects that by the year 2020 as a country we will spend one-fifth (19.8% to be exact) of our GDP on health care. Currently, we’re spending 17.6% of our GDP on health care which is significantly more than other country, meaning that our health care spending crisis is only going to get worse.

Why is this happening? It’s because the growth rate in health care spending is projected to be 5.8% each year until 2020. Since the economy is projected to grow slower than that, this means that more and more of our money goes towards paying for health care. Spending more on health care means that we have less money to spend on food, clothing, housing and transportation.

I’ve seen these choices made by my patients. One woman in her 60’s had high blood pressure and despite being on two medications, her blood pressure wasn’t coming down. After the second time this happened, I dug a little deeper than my usual question about whether she was taking her medications. I asked her how many pills she had left and at that point she told me that she was taking her pills every other day. One day she would take one pill and the next day she would take the other pill. She did this because the second prescription I gave her cost so much that she needed to save money to pay her rent next month.

Another patient of mine told me that he was going to have to walk home, because he wouldn’t have enough money to pay for the prescription I gave him and for bus fare. The worst thing about it was that the prescription was for a cane because he had bad arthritis in both his knees. A walk in November was not going to make his knees feel better.

As costs continue to rise, more and more people will have to choose between health care and their other needs. Until we get a handle on health care spending and make some tough choices people will be making more and more of these tough choices.



 (Photo by ashraful kadir via Flickr)

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