What if I presented you with the following data on health care costs in the US (these are roughly 2009 dollars)?
1972: $54 billion
1980: $116 billion (doubling in less than a decade!)
1990: $200 billion
2000: apx $320 billion
You’d likely point to the 6-fold real increase in “costs” and say, “yep, that’s a major problem.” I don’t want to get into whether or not that is a problem right now, or whether it is correct to call these expenditures “costs” I want to raise quite a different issue. What issue?
Well, the data from above represents (roughly) the total spending on pollution control (public and private) in the United States since 1972. Direct pollution control spending now takes up about 2% of GDP, far larger than at any point in our history. And the increasing cost of pollution control is making it harder and harder for ordinary Americans, whose wages have stagnated since 1980 while the richest Americans have seen their incomes explode, to secure the pollution control that they want. For some families, they are having to face the hard choice to consume more pollution control, or other basic necessities. Therefore, it is imperative that Congress steps in and does something before the nation is bankrupted, and 50 cents on every dollar is “taken up” by pollution control.
Of course, all I did was replace “health care” with pollution control from the way the health care issue is typically presented. Yes, health care does “take up” a far larger share of our expenditures now, so perhaps that is a justification as to why that is different? If we want to take up that route, then as compared to 1900, “non-necessities, where I include health care in necessities” have increased from being only 27% of our spending to over 47% of our spending.
Ironically, one thing I agree with from the health reform perspective is that it is very likely that health spending can be reduced considerably and we would not expect to see much of a decline (if any) in measured health outcomes (see here for an example). But then how come these very same “reformers” refuse to make the same observation when it comes to public education, public environmental spending, regulatory expenditures, and the like? They may dance around and conjure up some explanation, but it does not rescue them from the utter inconsistency of these views. So what is it going to be? I’ll jump in bed with ya on health reform if we reform all of the other “costly” spending items too.