Itâ€™s a very thoughtful and provocative essay about what we, as a society, receive for what many pundit, pols, and MSM savants derisively refer to as â€œspiraling health care costs.â€
Mr. Leonhardt writes, â€œLiving in a society that spends a lot of money on health care creates real problems, but it also has something in common with getting old. Itâ€™s better than the alternative.â€
As David Cutler (our second favorite health economist) points out in â€œYour Money or Your Life,â€ in 1950 the average American spent less than $100 a year ($500 in todayâ€™s dollars) on medical care. That number today is $6000.
And, according to Leonhardt, â€œMost families in the 1950â€™s paid their bills, but they also didnâ€™t expect much in return. After a century of basic health improvements like indoor plumbing and penicillin, many experts thought that human beings were approaching the limits of longevity.â€
Remember what biologist Rene Dubos wrote in the 1960â€™s, â€œModern medicine has little to offer for the prevention or treatment of chronic and degenerative diseases.â€
As Walter Wriston famously quipped, â€œThe future isnâ€™t what it used to be.â€ He was wrong. And so was Monsieur Dubos.
Dan Quayle was more on the mark (kind of) when he said, â€œThe future will be better tomorrow.â€
That's turned out to be surprisingly prescient.
Mr. Leonhardt points out that perhaps â€œspiralingâ€ costs are, well, worth it. â€œA baby born in the United States this year will live to age 78 on average, a decade longer than the average baby born in 1950 â€¦ If you think about this as the return on the investment on medicine, the payoff has been fabulous: Would you prefer spending an extra $5500 on health care every year â€“ or losing ten years of your lifespan?â€
And what do you think the proponents of so-called "rational use of medicine" would have to say about that? Ultimately, they say what Leonhardt points out as both true and frightening -- "that the best way to reduce health care spending is to reduce health care itself."
That is not acceptable in our affluent society. In First World societies health care is precisely how we should spend our money. As David Cutler writes, â€œWe have enough of the basics in life. What we really want are the time and the quality of life to enjoy them.â€
And to do this we must be able to choose the health care (yes â€“ even the pharmaceuticals) that are best suited to our individual needs. Choosing to support spending on health care means choosing life.
Health care: it's where pro-choice meets pro-life.