Response on health care spending

I am writing in regards to this publication.  You were listed as the ones to ask questions of.  

bls_emblem_sml.jpgBureau of Labor Statistics
The latest Beyond the Numbers article is available here: Highlights are below. What is driving increases in healthcare spending? Observations from BLS disease-based price indexes12/04/2020

I have been a student of price rises in healthcare ever since a hospital expansion ran over my neighborhood about 15 years ago.

I respect the data driven process you used, but I think in some ways you missed the big picture.

To me the key factor in health care cost rises is that healthcare is integral to the economic growth schemes of governments across the country.  Growing the medical industrial complex is a critical part of the economic plans of almost every city and state.  Almost by definition If the medical industrial complex is going to be a driver of economic growth health care spending must go up faster than the overall growth rate, which means that everyone who works in an industry growing at the national rate or below is going to fall further and further behind, which has been demonstrated to lead to ever more medical bankruptcies.  

If the overall spending on health care is going up based on the fact that people are consuming health care at an ever increasing rate, a rate much faster than the growth in population, while at the same time more and more people are falling behind on their heath care bills, there is clearly a market failure.  Prices are not based on ability to pay.  Which leads back to the original point, government wants the amount of money sloshing around the system to increase, and while constantly bemoaning how expensive health care has become, does everything it can to encourage the amount of money sloshing around to increase.    

This might be a smart strategy if it improved the delivery of healthcare combined with eliminating the causes of medical debt and bankruptcies.  Considering that the US ranks 37th in healthcare delivery, with life expectancy diminishing, suicides and overdoses shooting through the roof, and rural areas losing their hospitals, it seems a ridiculous  strategy.  But one the lobbyists love.  

An additional factor to consider is that all your statistics help us ignore a key factor.  Why are Americans sicker?  Why are they going to the doctor more? There are many factors involved, but one that needs to be factored in to the equations and never is, is that the pollution , stress, bad diets, poverty, racism, and injustice is killing people, and that a concerted effort to improve public health would cost less, help the economy more, and reduce the amount of health care spending, but that does not make the lobbyists or hospitals with the growth mentality  happy so they rig the system.   The US response to the pandemic of Covid-19 makes the case quite clearly.  Air pollution makes it worse, the poor and people of color get it more, get sicker and die more frequently.  The government traffics in dirty polluting industries and dismantles the public health system.  That increase expenditures for direct health care while worsening the healthcare results for most Americans.  

I would appreciate your thoughts, and I would appreciate the BLS looking at the real problems and searching for real solutions rather than the problems incurred because of the stupidity of the American government and its disregard for the public health.  


Greg Gerritt 

Director of Research

Providence RI