The sick economy isn't the only reason for diminished access to care. Another is inflated treatment costs. As we have noted on this page many times, the U.S. posts the world's highest prices for most procedures and goods yet falls far behind counterparts on measures of public health.
More evidence of skewed costs came last week from University of Pittsburgh health researchers. They reported in the Feb. 9 New England Journal of Medicine that drug prices and not the amount of drugs prescribed account for regional differences in Medicare Part D spending. The Pittsburgh team examined 2008 data for 4.7 million beneficiaries, looking at three widely prescribed categories of drugs—blood-pressure medications, statins and antidepressants. Researchers found that more than 75% of the difference between high-cost and low-cost regions was due to the cost per prescription.
They concluded that greater use of lower-cost generic drugs could substantially reduce spending and out-of-pocket costs for beneficiaries.
Drugs account for about 10% of national health expenditures, according to government figures, so they shouldn't be singled out as the primary cause of soaring spending. But the phenomenon described by the Pittsburgh researchers is emblematic of a healthcare system with extraordinarily high markups.
The healthcare system in total presents a dichotomy Dickens could appreciate: high prices and overuse of services in some quarters and underuse (with all the deleterious consequences) in others. Until we straighten out that system, there will be more Hard Times.