Solutions to problems are generally sought from within the problems themselves. Two recent examples are healthcare and finance. In both cases, the solutions are believed to be better-structured and regulated systems. In blogs, articles and speeches, I have stressed that — while there are myriad ways that healthcare can be improved — the real solutions to high healthcare spending lie outside of healthcare.
Poverty and its associated manifestations are at the core of the healthcare spending crisis. The high costs of caring for the poor will continue to overwhelm the system, no matter how it’s structured and improved. Rather than looking for solutions through changes in process and regulation, the major solutions to healthcare’s excessive spending reside in areas such as K-12 education, neighborhood safety, and the creation of jobs that can lift low-income families from the cycle of poverty.
Simply stated, the U.S. does not and will not have the resources to provide equitable care for those among us who confront inequitable circumstances in every other aspect of their lives.
Raghuram Rajan, a distinguished professor of finance at the University of Chicago and former chief economist at the International Monetary Fund (IMF), has come to the same conclusion about our financial system. In his new book, Fault Lines: How Hidden Fractures Still Threaten the World Economy, he describes how cheap credit was a mistaken remedy for the consequences of poverty. In addressing its financial future, the U.S. will have to place greater emphasis on educating its young and creating a safety net for its poor.
Neither cheap credit for those who are too poor to pay it back nor costly healthcare for those whose poverty creates the demand for more, nor even more primary care physicians to treat their woes, can hold our society together. The fault lines of income inequality are the nation’s greatest challenge.
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*