Although insurers get a lot of attention when problems with the current health care system are discussed, such discussions are often a case of missing the forest for the trees. This is because the issue of preventive versus reactive care is much bigger and a much bigger impact on costs.
The current effort to reform health care in Washington is a much needed thing although the merits of the current effort are certainly generating a lot of heated debate. Despite the positives and negatives of the bill, what is clear is we need to do something because the cost of health care in the richest country in the world is simply out of control.
One of the biggest problems with health care is the approach we take. We focus almost entirely on treating diseases and health problems. Almost no effort is given to preventing them. This is a huge mistake because the cost of treatment is massively larger than the cost of prevention. Numerous programs have shown that spending just an hour on preventive care with patients would save tens of billions of dollars a year in medical cost.
So, why do not we see more preventive care? The answer is somewhat morbid. It simply does not pay as well as reactive care. If I see a patient four times a year and put them on a strict nutrition and exercise plan, I might make $ 400 or so for the visits. If I see a patient only when they come in with a complaint, I will make far more than that in a single visit after I conduct an exam, order a bevy of tests and so on.
The vast majority of doctors do not think of the process in this way. They do not have to. It is the accepted approach to medical treatment in this country and a major reason why costs are so high compared to practically any other nation. Until we develop a different approach, that simply is not going to change.