After all is said and done about controlling the waste and excess of America’s corporate-led health care system, the cost of care, experts say, is still going to go up.

Washington Post health writer David Brown puts it this way: “Medicine lies at the intersection of two profound forces. One is the desire to survive, which motivates all living things. The other is the ability to make things, which distinguishes humans from other animals.”

Drew Altman, head of the Henry J. Kaiser Family Foundation, makes a similar point. “At the end of the day, when it comes to controlling health care costs, the enemy is us. Americans want the latest and best in health care technology, and we want it down the street, and we want it now.”

In the early decades of modern medicine, small, inexpensive advances reaped tremendous gains. For instance, the discovery of a vaccine for smallpox saved tens of thousands of lives annually and for only pennies a shot. 

Today, however, further advances derive from investigation of highly specific health problems that involve relatively small groups of people, and it costs a lot more to make smaller gains. For example, studies show that an implanted cardioverter-defibrillator (ICD) can extend the life of a heart attack victim by one to three years more than medication alone, but it costs about $30,000 for each of those years. Yet, which one of us with a serious heart problem wouldn’t want it, especially if insurance will pay for it?

“If insurance will pay for it” – therein lies the rub. Do we really want insurance to pay for anything and everything, no matter what the cost? For Laborers, as rates continue to soar, “insurance pays all” ultimately translates into smaller pay increases. Averaging across society, Americans currently pay about 16 percent of the gross domestic product (the total value of all the goods and services we produce) for health care. In just seven more years, that portion will rise to 20 percent. By 2075, it will hit 38 percent.

If we can’t have insurance pay for everything, what is the other option? Since we cannot know what illness may one day affect our life, our best option is maintaining good nutrition and fitness from childhood, getting appropriate vaccinations as scheduled during childhood and, as adults, regularly seeing the doctor for check-ups to find problems before they become serious, debilitating and costly. By restoring balance between the individual and society for both the management and cost of health care, this kind of personal responsibility strengthens the overall system and improves the well-being of each individual.

Organizations can help. LIUNA’s health and welfare funds are helping Laborers and their families get more involved in their own health management (see Ideas that Enhance Service and Contain Costs). These efforts will pay big dividends.

[Steve Clark]