You're absolutely right that it's not only natural, but desirable, that health care costs, as a percentage of total costs, go up. After all, the state of health care today is far beyond that a century ago. And the demand is virtually inelastic (what's the maximum that you would you pay to save a doctor save your, or a loved one's, life)?

On the other hand, not all of us with health insurance are insulated from the costs. I have (by choice) a $1000 deductible and in all of my 41 years on this planet I have never had an insurance company pay a penny of my health care costs (well, maybe when I was born -- I'll have to ask Mom) -- although I've paid plenty in premiums.

Also be careful with the "standard of living." Yes, by purchasing power parity we may have the "highest" standard of living but PPP is but one of dozens of measures of living standards. On the others (hours worked per annum per capita, health care access, stress, etc.) we're somewhat down the list.

greg, in "I'm sitting at home with a broken leg so, this year, I may actually exceed my deductible" mode

On the other hand, not all of us with health insurance are insulated from the costs.

Yes, that's precisely why I wrote, "But all of that is starting to change, and in the process so too will the care that we receive."

And I used PPP for a specific reason. I don't need to be reminded of other measures of living standards. But I will note that "hours worked per annum per capita" is a relative measure that doesn't tell us much, especially in the capitalistic U.S., where people often choose abnormally high hours even when the need for it is absent.

And when you consider that, in France, many people can't work more than 35 (37?) hours a week now, and that in much of the rest of Western Europe, high taxes discourage workers from spending more time at the office and high costs of training and firing discourage firms from taking on new workers in the first place.

The bigger point, though, is that for all the money we spend on health care in the U.S., our outcomes are miserable. We are probably either the least healthy or close to it among the developed world.

"And the demand is virtually inelastic (what's the maximum that you would you pay to save a doctor save your, or a loved one's, life)?"

But! Most medical costs are paid for by third parties, and so the question isn't how much I'd pay to save my life, but how much I'd like Blue Shield (or Uncle Sam) to save my life. The latter figure is very much higher than the former.

And, Greg, I take it you're denying the existence of a bequest motive, not to mention the studies Mallaby cites in his op-ed about implicit valuation of life.

An interesting somewhat-related post on health care costs at Political Animal:
http://www.washingtonmonthly.com/archives/individual/2005_01/005508.php

And, Greg, I take it you're denying the existence of a bequest motive, not to mention the studies Mallaby cites in his op-ed about implicit valuation of life.

I'm not denying them. I'm just ignoring them because, so far, I've been too lazy to read them.

greg, in "what's worse, apathy or ignorance? I don't know and I don't care" mode

"But insurers have an incentive to focus on cost,..." Really? Then why do they contribute so very much to doctor's costs with their bureaucracy? They make the government look like pikers. How many insurance companies are there? How many different forms, different requirements? How many employees do doctor's practices add just to deal with it? How much does all of that cost us?

My problems with the attempts to imply that health care is like any other commodity to be shopped around for is that I seriously question that there is enough information out there to enable anyone to shop for health care on a truly rational basis. And it is completely impossible for any disease with a sudden onset requiring rapid treatment that your G.P. can't deal with or for accidents.