Why Health Care Costs Continue to Rise

John M. Kutch, Jr., D.P.A., F.A.C.H.E., Medical Anthropologist Consultant, Retired National Health Service Corps Officer, United States Public Health Services, Grapevine, Texas

Almost every time I pick up the newspaper, there is some story or article about the rising cost of health care. While driving along the Interstate, large billboards catch my eye with a message about health care that implies quality, caring, accessibility, and affordable costs.

Political candidates always include statements about the cost of health care and mention that the costs are rising and that we need to find new ways to manage and cover the costs. Strong arguments are made, and backed with sophisticated documentation, that support positions taken to explain the year-to-year increase in costs and what rate cuts, if any, should be implemented.

During election time for both rural and urban settings, the cost of health care becomes a grass-roots issue. However, information widely published and read by the public often concentrates on which health care costs are rising instead of why they are rising and will continue to rise.

• The reasons why health care costs continue to rise are numerous. Consider the following:
• Emergency situations and serious health conditions are, by their very nature, going to be expensive.
• It is assumed that all persons are entitled to medical care, regardless of their ability to pay for it.
• New equipment and supplies, safety and maintenance costs of existing equipment, and the increasing requirements for highly trained personnel at higher salary costs are expensive.
• Both health organizations and practitioners are subject to the forces of economic markets. Changing laws and regulations control almost every aspect of health care delivery and the costs of complying are built into the patient billing process.
• Health care costs go up as a direct result of the pushing forward of the frontiers of technological applications in health care. It is obvious that it costs less money to allow a patient to die in a relatively short period of time and without doing anything really effective, than it does to prolong the same patient's life, or perhaps even cure the patient with very expensive treatments and procedures such as chemotherapy, an organ transplant, open-heart surgery, or a total hip replacement.
• Adding to the costs are the competitive demands for highly trained health professionals, most of whom are encumbered with huge student loans from their academic careers and are mobile enough to seek work in higher compensation locations.
• Last are the medico-legal requirements, fully supported by the courts, for laboratory testing and X-rays, to accurately diagnose and treat conditions as well as monitor the course of treatment.

All of the above give the answer to "why" the costs of health care increase and will continue to increase.