In my vast storehouse of boring, wonky hobby horses, an old favorite is that it's not Medicare which is in financial crisis, but health spending more generally. The question is one of cost inflation, not aging, or underfunding. So I'm glad to see David Leonhardt get his hands on this CBO graph:
If the issue were simply aging, cost containment would be, at best, a minor problem. It's health spending. And the growth is actually slightly faster in private insurance -- which we'll all be paying for, but because it's not coming from taxes, we get fewer nifty graphs and newspaper articles on the problem. But in the end, there's no solution here that doesn't reform the whole system. Cost containment really is key -- and it needs to fixed systemwide.
Part of that is encouraging less treatment. Lumbar surgeries, which are increasingly common, aren't particularly effective. The evidence in their favor is very, very weak, and often contradictory. Many patients recover just as well, and often better, without any surgery at all. But there's another driver too. "Doctors are almost always better off if the surgery is done," writes Leonhardt. "The typical hospital bill for lumbar fusion is roughly $50,000."
