Medicine has evolved tremendously over the past 60 or 70 years, thanks to innovations like penicillin and MRIs. And yet, says Dr. David Gratzer in this penetrating interview, our health care systems, both in Canada and in the United States, suffer from serious inefficiencies. “We spend more than we’ve ever spent on health care, we have more administrators than we’ve ever had, and more bureaucratic rules as well, and yet the system still falls short.”
Most glaringly, the cost of health care has been rising fast for many years. Improved care is part of the explanation, but inefficiency also plays a big role. And inefficiency can be traced back to the fact that individuals who use health care are divorced from its costs. Not only does insurance pay for many health care expenses, but we are divorced even from the cost of insurance, which for most people is provided by government or employers. When the people paying and the people using are not one and the same, there is less pressure to keep costs down.
“If you look at what happens in a free‐market system,” Dr. Gratzer explains, “if you’re talking about food or clothing, what you find is that over time, value increases and prices fall.” Think of what has happened to long‐distance charges or the cost of personal computers in the past decade or two. There is no reason why the same thing would not happen to the cost of MRIs and CAT scans in a free market with price transparency and competition.
Viewers will also hear the doctor’s views on pharmaceutical companies and on what to do about the obesity problem. He closes with some thoughts about health insurance: While he firmly believes that we need it, he does not think it should cover routine expenses. After all, do we expect auto insurance to cover the cost of filling the gas tank?