Engineering and Health Care Reform

Engineering is in competition with the health care industry. As a nation, we now spend 18 percent of our GDP on health care. In 1966, Medicare and Medicaid made up one percent of total government spending; now that figure is 20 percent, and quickly rising. The federal government spends 87 times more on health care than on our water supply.

Competition - in the form of a giant vacuum cleaner that keeps gobbling up capital and natural resources. It is seen as an island that doesn't touch or affect the rest of the economy. It is a competitor such that health care demand has no natural limits. It is a beast of immense size and power.

Columnist David Brooks of the New York Times makes the point that many industries have an interest in making sure health care spending rises to 20 percent of GDP, and then 22 and then 24. The engineering community is not one of them. There are statistics and then there are trends - and the competition trend line between engineering and health care is not looking good. The current health care system is outrageously expensive, dysfunctional, and economically corrupt - every percent increase in health care GDP takes money away from highways, water treatment, national defense, the new family car, etc. It directly displaces engineering opportunities at an alarming and ever increasing rate.

David Goldhill in his The Atlantic article "What Washington Doesn't Get About Health Care: Here's How to Fix It" does a first class job writing about the inadequacies of our current system. The story is a tale of Goldhill's 83-year old father and his five-week stay in ICU. For Goldhill, the cost issue is just one side of the story. The other side is the poor performance of our system. Goldhill writes:

"I'm a businessman, and in no sense a health-care expert. But the persistence of bad industry practices - from long lines at the doctor's office to ever-rising prices to astonishing numbers of preventable deaths - seems beyond all normal logic, and must have an underlying cause. There needs to be a business reason why an industry, year in and year out, would be able to get away with poor customer service, unaffordable prices, and uneven results - a reason my father and so many others are unnecessarily killed."

Brooks addresses this head on, " . . . did Barack Obama really get elected so he could pass the Status Quo Sanctification and Extension Act." Goldhill further writes:

"How would the health-care reform that's now taking shape solve these core problems? The Obama administration and Congress are still working out the details, but it looks like this generation of "comprehensive" reform will not address the underlying issues, any more than previous efforts did. Instead it will put yet more patches on the walls of an edifice that is fundamentally unsound - and then build that edifice higher."

David Goldhill's father was working at his job the day he entered the hospital. Within 36 hours, he had developed sepsis. He died five weeks later. The hospital bill came to $636,687.75