Health Care Reform’s Elephant in the Room
Monday, October 5, 2009
There may not be a simple solution to the complex problem of reforming health care, but bioethicist Mark Aita, S.J., M.D., assistant director of the Institute for Catholic Bioethics at Saint Joseph’s University in Philadelphia, is certain of one thing – the elephant in the room that no one wants to discuss is that insured Americans contribute to the problem.
“Most Americans are blessed with too much health insurance, and we do not use it wisely,” says Aita. “Many expect the most expensive treatments, but the costliest treatments aren’t always necessary. We blithely say, ‘my insurance will pay for it’ without realizing that, in the end, we all pay.”
Aita, a trained physician and Jesuit priest, says the insured have an ethical responsibility to maintain or improve their own health, which in turn, will help control costs. “While it is impossible to implement a program forcing people to live healthy lifestyles, it is reasonable to assume that healthier living leads to lower costs.”
According to Aita, technology also drives costs. “Health care economists say the control of technology is the most important factor in bringing costs down. They estimate between 40 and 50 percent of annual cost increases can be traced to new technologies or the intensified use of old ones.”
But controlling health care costs – especially those associated with technology – requires a change in American culture, Aita says. “The problem is that patients expect high-tech care; physicians are trained to use it, medical industries make billions selling it and the media loves to write about it. Technological innovation is as fundamental a feature of American medicine as it is the industrial sector, and there is fierce opposition to any limitation in the use of medical technology.”
Effective controls will force patients to forgo treatments they do not need, doctors to sacrifice to a considerable extent, their ancient tradition of treating patients as they see fit, and industry to reduce its drive for profit, says Aita.
“The fact that European countries can control costs and limit technologies without harming health is a patent rebuke to our way of doing things. It’s time for us elephants to forget, and let go of the old way of doing things, so that all Americans benefit from health care.”