Chapter 11: Conclusion: Containing the Cost
In spite of the countervailing forces, and in absolute terms, the total cost of care is going up. There is nothing wrong with that. If society wants better health, and if it is convinced that more care is the best means to the end, then it ought to welcome the rise. We do not cut or contain the cost of something that is doing us good. The share of foreign holidays, handphones, new cars, video games and owner-occupied housing has gone up as well. You get what you pay for. Every child knows that. The debate is not about whether citizens in a liberal democracy should be denied access to a consumable that they crave. The debate is about whether extra care actually produces extra health. It is about whether an equivalent health status could be delivered at a lower cost. It is about whether health care at the margin is crowding out other consumption and investment opportunities that citizens if properly informed would have ranked more highly. The debate is also about the pressures on the State budget, the crisis in public finance and the threat to under-publicised areas of public expenditure. The debate, in other words, is about the optimum. What level of health care and what rate of growth are the targets at which the society ought to aim? It is not an easy question to answer. There is no consensus on what it is that medical spending actually does: ‘The nature of the link between medical-care...
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