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ECONOMIC CONSTRAINTS ON HEALTH CARE
Author(s) -
Goldman Fred
Publication year - 1981
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1981.tb15444.x
Subject(s) - annals , citation , public health , health care , library science , administration (probate law) , sociology , columbia university , political science , media studies , classics , medicine , law , history , computer science , nursing
The phenomenal rise in the money size of health services during the second half of the 20th century has led to the preeminence of the health care industry as a major force in the U.S. economy. National spending on health care increased 13-fold between 1950 and 1977, from $12 to $163 billion. Health care spending today accounts for nearly one in every eleven dollars of gross national product.’ Unlike other industries, where a rise in indicators of growth generates nearly unanimous celebration, growth in the health care industry is met with a wider variety of responses, most tipping toward dismay. Only secondarily if at all is the expansion process in the health care industry viewed as “more jobs,” “more income,” or perhaps “more health.” Yet, the health-care industry is now the third largest income-producing industry in the nation and the nation’s largest employer, currently accounting for one of every 20 members of the U.S. labor force, and growing.’ The command of the health industry over national resources is generally viewed as a public sector embarrassment. It signals the failure of public policy and planning in an area marked by wholesale defection of large segments of the industry from a modus operandi susceptible to market forces, precisely the conditions under which public intervention is deemed desirable. The growth is also viewed as a threat to the economy, in general, as ever greater public and private spending is required to keep pace with the costs of obtaining health care. Health care costs also enter the ledger as a cost of doing business and, thus, find their way into product prices. One recent book title asks, Health: A Victim or Cause of In~at ion?~ As the point is alternatively put, “the cost of health insurance is a larger component of an automobile’s cost than ~ tee l . ”~ The ongoing health care crisis, once a crisis of access and equity, later a crisis of efficiency, is now a crisis of costs. This paper examines the predominant behavioral explanations of the rise in health care costs and brings into relief the less frequently explored role of the economy’s impact on health care.