Paul Ryan’s health care cuts won’t help health care

Cutting the budget won't necessarily improve health care unless patients opt for changes in treatment. Photo: A doctor examines a patient

SALEM, Ore., March 13, 2013 — Congressman Paul Ryan (R-Wis.) proposed a health care budget to increase the number of people who lack health insurance in the United States. He proposes to make cuts to Medicare, Medicaid and President Barack Obama’s health care reform law that would then reduce the total $2.72 trillion over 10 years. 

When you look at the medicare waste, this may be a good thing. At least Mr. Ryan is looking to cut $4.63 trillion from the current budget; that’s 59 percent of the total in cuts contained in Ryan’s budget-balancing plan. That’s great, Mr. Ryan, clean up the budget.

But what you’re going to find soon enough is that many people, the average health-care consumer, may not even care. According to a recent study in the journal Health Affairs, people willingly drive across town to save 50 cents on a carton of milk. But when it comes to health care, they don’t want to think about how much it costs, and they don’t want their doctors to think about it either. 

“Our findings present some challenges to doctors and to policymakers, insurers, employers — just about everybody who’s concerned about the rising cost of health care,” says the study’s co-author Susan Dorr Goold at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan.

Most people do not understand how insurance works. In addition, most people feel little personal responsibility for keeping health costs lower. “If someone else pays for it, what do I care?”

Also when people are presented with two options of care, one expensive and the other less expensive, they will more often choose the more expensive option, even if a less expensive option was nearly as effective as the more expensive choice.

In addition, people seem to be antagonistic toward insurers and seemed to be motivated to choose expensive care out of spite. “There was an almost vengeful attitude toward insurance companies,” says Goold.

Still, Goold says she’s somewhat optimistic about the possibility that people can be encouraged to change their attitudes about weighing medical costs. She pointed to changes in end-of-life care over the past 30 years as an example. As hospice and palliative care have become widely accepted, the focus of patients, their families and providers has shifted towards improving quality of life through pain and symptom management rather than necessarily extending life.

So as the politicians are reducing healthcare costs, people need to become more responsible in their decisions about health and what they can do to improve themselves. In reality, health insurance, Medicare included, have nothing to do with health. Health is an inside affair. American consumers have released this responsibility to insurance companies and more recently to the government. 

Dr. Peter Lind practices metabolic and neurologic chiropractic in his wellness clinic in Salem, Oregon. He is the author of three books on health, one novel and hundreds of wellness articles. His clinical specialty is in physical, nutritional, and emotional stress. 

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Peter Lind

Dr. Peter Lind has written five books about healthy lifestyle and specifically subjects such as food, diet, nutrition, exercise, and stress. He has written one thriller about agriculture genetic engineering that has been written into a screenplay. 

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