Sources of exponential growth of medical costs
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Anil Mitra, Copyright © 2007
The following are ideas without analysis. I plan to do an analysis in the future
Efficiency
Over-regulation (laws pertaining to licensing, licensing)
Non-focal approach; focus on peripheral factors
Over focus on confidentiality (which in the long run is counterproductive regarding societal attitudes)
Elimination of cheaper sources of care that results in no care, unaffordable care, burdening of emergency rooms, long trips from rural areas to urban treatment centers
Over-administration
Proliferation of players other than care providers
Over-professionalization and over-payment—compared to other fields
Elimination versus enhancement of family and social networks
Redundancy—e.g. time spent on documentation far exceeds what is needed for cohesion and continuity of caring
Insurance
… And changing—and changed—attitudes of large corporations from function to profit
Consolidation of hospital and other sources of care which eliminates competition
Increasing number of uninsured which causes providers to over-charge employer based plans
Investment
…of other contractors and providers
Technology including pharmaceuticals
Increased use of new technology and drugs
Societal attitudes to health, illness and death… expenditure on marginal benefits
Economics of large institutions—marginal costs
(Mention of marginal analysis does not imply that the result of such analysis is ethical even if it is efficient)
Supply and demand of skills (doctors, nurses, various therapists and technicians)
Attitudes toward government and services
Demographics
Aging population
Increasing incidence of costly chronic conditions like diabetes, obesity and heart disease
Another meaning of ‘cost’
The cost to society and individuals associated with the practice of medicine (the nature of the practice, errors, and ethical concerns) and attitudes toward it