N. Gregory Mankiw’s article “Why Health Care Will Never be Equal” http://bit.ly/2m0wzU describes only two legs of the three legs of health in America. He excludes from his equation the fact that compliance by individuals and their physicians with known guidelines for care can reduce medical risk and increase longevity at dramatically lower cost. These efforts can reduce as much as a third of the money spent today for health in America. This amount of money is more than enough to pay for everyone and even leave a little over for other items to reduce our national debt.
We are overweight, comply with recommendations for diabetes management less than 50% of the time, and do not get screened for cancer when we should. These low cost non compliant behaviors insure the continuing supply of patients who wastefully consume our health dollars. We have become dependent on the bail out of expensive medicines and treatments instead of taking actions to avoid their use in the first place.
In addition, significant proportions of Americans who take multiple drugs have adverse drug reactions (not drug interactions) and are not aware of them. These idiosyncratic (Specific to each individual person response to medicines) reactions often lead to unnecessary tests and hospitalizations. In fact, the Institute of Medicine has reported on average five thousand dollars of every hospital admission is spent on the clinical presentation of adverse drug reactions.
Dr. Mankiw does not address the contributions to society that result from the investment in life years gained from treatment.
We could avoid the ethical dilemma raised by Dr. Mankiw, if our culture changed to simply follow a more logical approach to health using available information technology correctly.
The Health Gadfly