Will health care melt down, like the mortgage industry?

Clearly, one issue dominated the election this past fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don’t necessarily have the answers, but I’m real good at asking questions.

Did government assisted mortgages help the economy? Certainly by artificially lowering mortgage rates and the creation of investor owned, government back sub-prime mortgage equities, the federal system of assistance in home buying has become the norm.

But given the meltdown in the mortgage industry, did we do a service to Americans by putting people in homes they couldn’t afford? Flipping houses became the source for a evening cable television show and the folly of many particularly young home buyers.

As liquidity in the mortgage market disappeared so did the dreams and savings of many Americans — including those that had invested in the “government” back equities of Fannie Mae and Freddie Mac.

Is government funded healthcare going to be beneficial for our country in the long term? Just like mortgages, are we going to put our country into a health system they can’t afford?

Out current federal health legislation creates “coverage” for 85% of our citizens, but does nothing to promote access to care or an improvement in health care choices.

The latter is particularly concerning.

Regardless of the life style choices one makes, there is a guarantee of coverage. There certainly needed to be an improvement in health care services for the uninsured, and there needed to be some limitations on the growth in spending, but wouldn’t it have been better to put incentives on the user?

The real question becomes: will we be facing a health care meltdown just like the mortgage industry? As the requirements for health care services rise, there being no limitations on cost, and no impediments to limiting health care decisions, can the system continue to function?

The biggest concern here is whether physicians and other health care industry providers (pharmaceutical companies, insurance companies, hospitals) can continue to function in an economic environment of continued declining reimbursement for services.

This is especially true given the proposed 23%+ cut in Medicare rates next month with more to follow in January.

Will there be a decline in health care liquidity?

Physicians and other health care providers may find themselves in a situation much like the mortgage industry: servicing consumers with health care services they and the government really can’t afford.

I guess the real question is will there be a foreclosure on your new sub-prime health coverage?

Dan McCoy is a dermatologist who blogs at docdano.com.

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  • jsmith

    Curious post. The mortgage industry melted down because of propagation of shocks through the highly inter-linked financial system. The medical system is structurally totally different.

  • lhauser

    The structural differences in the system are irrelevant in the end. One only has to look at the continually rising costs of healthcare to realize that either the healthcare system will see some sort of cost/reimbursement reform, or the system or the nation will “melt down” around it.

    • jsmith

      A melt-down implies rapid ( a few days to a few months) deterioration. The nuclear reaction origin of this term implies rapidity due to interlinking (a chain reaction).
      Gradual deterioration, even of a great degree, is not a melt-down.

      • http://notwithstandingblog.wordpress.com The Notwithstanding Blog

        @jsmith, I think you’re conflating the problems in the mortgage market with the way in which those problems brought down the entire financial system. Even with the degree of interconnectedness and leverage that brought everybody crashing down at the same time, the problems in the mortgage market were real, and similar to that in medicine: an unsustainable influx of government-subsidized spending reaching its end.

        I can’t help but think that whether you want to call it that or not, medicine is in a state approximating a “bubble,” and that the PPACA will only make it worse before it gets better. Whether it goes back to Earth via a bang or a whimper… we’ll see. But that the current levels of spending are widely seen as unsustainable strongly implies that those who benefit from the money (i.e. the health care sector) will be getting their wings clipped sometime within my lifetime.

  • gzuckier

    it’s not the same as the classical bubble, which involves people buying and selling the same thing to each other at ever-increasing prices, be the item houses or tulip bulbs. nobody’s reselling the operation they paid $5000 for to get a $1000 profit. but there is certainly ever-increasing prices, and there is definitely going to be a hold on that. the sudden ramping up of medical cost inflation took the insurance actuaries by surprise for a decade so they got stuck with the cost, but the models are better aligned with reality now and the insured are sucking up the cost; but that’s obviously not going to last and the insurers are already scrambling to get their payouts under control; guess whose turn in the barrel it is now?

  • Dorothy Green

    “Regardless of lifestyle choice, there is a guarantee of healthcare”.

    That is by far the costliest aspect of Medicare, Medicaid and the uninsured. It affects all taxpayers and is the one of the major causes of premium hikes besides the need to maintain high CEO pay in light of no more pre-existing diseases. Will politicians discuss this issue seriously? – Probably never – with 70% of the present or potential voters being overweight or obesity, less than 10% excercising etc. Iowa being such an important political state.

    There is a lot in the media about all the scientific reasons people eat to too much that totally ignore “what is out there to put into their mouths” and the “individual responsibility” for it. The propensity for addiction (the most widespread being that of unhealthy food) is part of the human condition, more in some than the others. It needs to be addressed as a cultural public health concern first and a medical problem second.

    Any ideas? I’ve shared my major one already.