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OPINION: Healthcare is too expensive overall, that’s the real problem

Politicians refuse to face up to the fundamental issue which is the overall cost of healthcare

In 2015, national healthcare expenditures grew 5.8 percent to $3.2 trillion, or $9,990 per person, and accounted for 17.8 percent of Gross Domestic Product (GDP), but are we getting our money's worth?  The details by type of spending or product, the major source of funds and type of sponsor can be found in the linked report

According to columnist George Will, U.S. healthcare spending alone is larger than all but four of the world's largest total national economies; I'll take his word for it because the comparison number isn't important except to say, "wow" — it's fast approaching $1 out of every $5 spent on anything in our economy and that is important. 

Healthcare in the U.S. became a de facto entitlement long ago. It makes no difference if you get it through your employer or from one of the countless government programs; Medicare, Medicaid, MediCal, the State Children’s Health Insurance Program (SCHtIP), TRICARE, VHA, and/or IHS — it’s almost all paid for or subsidized by the taxpayers directly or indirectly.  Out-of-pocket costs, which one has to assume includes co-pays, and might also be tax deductible, were only 11 cents on the dollar; the other 89 cents came from a government program or insurance.    

Those government programs alone cost more than $980 billion annually, tax expenditures for healthcare another $260 billion, and the value of the tax breaks are more than $1 trillion ($1,000 billion) over five years.

Additionally, there are the direct public costs at every level. For example, in 2015 the 1.3 million California county, city, K-12, and Special District employees who qualified for benefits received $10.7 billion in tax-free health insurance worth, on average, $8,100 each paid from public funds.

Someone without health insurance, employed or not, likely qualifies for some degree of help, subsidy or tax deduction, many qualify for several programs at the same time. Even the destitute get medical care.

All rolled together if that isn't an entitlement, I don’t know what is.

The U.S. is overflowing with medical care, maybe not where you want it and when you want it, but it’s available somewhere, always at a cost to someone. It’s a business and like any other business it tends to flock to the places and specialties where there is money to be made.

A heck of a lot of companies and people are making a living in the healthcare industry. More people are in it for the money than to be Dr. Kildare; there is no shame in that, but it’s important to remember that most products and services cost whatever the traffic will bear and there has been no traffic cop working on healthcare highway, so costs are out of control.

The Republicans believe they can get rid of the subsidies, they are only kidding themselves since everyone has them in one form or another; the Democrats believe that if they just got rid of the insurance company profits all would be well, they are as foolish as the Republicans because insurance payments are making up the difference in the cost and what the government pays which cannot sustain the system.

Both recently learned that lesson. First in California, where the Democratic-dominated legislature found itself unable to pay for the proposed $400 billion single-payer plan just to cover MediCal and some related programs, then in D.C. where the Republican-dominated House couldn't even pencil out a working alternative to the Affordable Care Act, itself nationally un-affordable in spite of its catchy title.

Both parties are afraid to take on the real problem, the cost, which means you have to take on the unions, the medical establishment from bottom to top, all their manufacturers, suppliers and service providers, and especially the entitled patients none of whom have any incentive to worry about costs. After all, they believe that it’s all OPM (Other People’s Money).

Marty Richman (Marty Richman)

Born and raised in Brooklyn, NY, Marty (Martin G.) spent his teen years in northern New Jersey. He served more than 22 years on active military duty, mostly in Europe, and is a retired U.S. Army Chief Warrant Officer 4, Nuclear Weapons Technical Officer.Marty then worked 25 years in various engineering and management positions in the electronics and energetic materials industries supporting the communications, computer, aerospace, defense and automotive sectors. He is a graduate, summa cum laude, from The College of Hard Knocks, among his numerous awards and accomplishments. He was a regular weekly Op/Ed columnist and feature writer for The Hollister Free Lance for seven years and a member of its editorial board for five years. Marty is a frequent commentator and contributor to BenitoLink on a wide variety of local, state, national and international subjects. You can follow Marty Richman on twitter @Marty_Richman. Marty and his wife, Joyce, have been residents of Hollister since 1996.


Submitted by Robert Gilchrist Huenemann (bobgh) on

One major reason that healthcare is expensive: Most of us (myself included) eat too much.Part of this is a hard wired survival instinct. Part of it is our own stupidity. But we are subjected to a barrage of propaganda from agribusiness. It's OK to advocate for eating more, as in more fruit and vegetables. But God help anyone who suggests we should eat less. Michelle Obama tried it and was promptly slapped down by agribusiness. And franchise restaurants will kill you. Literally.

There are organizations that help me to rein in my worst instincts. One is the Center for Science in the Public Interest (CSPI). Another is the American College of Lifestyle Medicine (ACLM). They have helpful publications and social media sites. I support both.

Submitted by Bob Easterday (mscientist) on

Unfortunately most politicians do not know the difference between health care and insurance and almost always conflate the two.

If they truly wanted to address the cost of health care, there would be siren calls for tort reform, changes in prescription patent law, and a serious overhaul of the FDA.

One of the few things where I agree with the Democrats is that Medicare should be allowed to negotiate drug prices paid by the government, in fact they should be forced to negotiate drug prices.  But the problem is always the same, both sides want to kill the other side's golden contributing goose, but never their own.

So, the Democrats want to kill the the profits of the drug manufacturers and the Republicans want to kill the untaxed bloated healthcare insurance benefits received by the unions - especially the public employees.

Therefore, nothing happens and we just keep running towards the cliff.

Marty Richman

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