Most of the media coverage about health care reform has focused on legislation rather than the big picture of the health care crisis. We are in danger of losing the forest for the trees.
Setting aside the current health care reform plan, let us consider at least three components contributing to the health care dilemma.

We begin with the most obvious issue: the ever-rising cost of health insurance, which seems to be the primary issue addressed in the current health care legislation.

A September 2011 report by the Kaiser Family Foundation paints a clear picture of the situation. According to Kaiser, in 2001 the average insurance premiums for family coverage through an employer averaged $7,061; by 2011 that average more than doubled to $15,073.

Though disheartening, this is likely not surprising to those who have observed their own health insurance premiums increase year after year.

While it would be convenient simply to label the insurance companies greedy and leave it at that, the story does not and cannot end here.

One must ask a seemingly obvious, yet often overlooked, question. Why do health insurance costs increase each year?

This brings us to the second component: the ever-rising cost of medical treatment.

Most insurance companies offer some details that, taken with a grain of salt, are informative regarding premium increases.

Blue Cross and Blue Shield states that inefficiencies in medical care – such as unnecessary testing and treatment, incorrect diagnoses/treatment, and operational waste – contribute to increasing insurance costs.

For instance, in 2008 the Congressional Budget Office estimated that 30 percent of annual medical tests and procedures were unnecessary, and in October 2011 the Washington Post reported that a physician-led survey concluded that a list of 12 overused (unnecessary) tests resulted in $6.8 billion in medical expenses in 2009 alone.

Even disregarding such information as biased finger pointing, awareness of excessive charges for a doctor’s visit or hospital procedure is widespread.

Reports on the cost for aspirin at hospitals are more comical than alarming, but reports on the cost of other procedures are alarming and not remotely humorous.

For instance, a recent Austin American Statesman report noted that an Austin man’s local ER visit lasted 128 minutes (most of which was spent in the waiting room) and resulted in a bill of $8,716 ($68 per minute) for his diagnosis of kidney stones.

In short, inflation of medical costs seems out of proportion to wage inflation.

We might be tempted to end our inquiry here and point an accusatory finger at the medical community, but we must ask at least one more question: Why does the cost of medical treatments continue to increase?

Many answers could be given – for example, a persistent lack of transparency in costs and billing across the medical community that prevents fair market competition in which consumers choose the best option.

Yet, there is a key factor we often neglect: you and me. Yes, we – who like to complain and write articles about greedy insurance companies and hospital conglomerates that overcharge us for their services – play a part in this drama, too.

Insurance companies often note unhealthy lifestyle choices, such as tobacco use, overeating and lack of exercise as factors contributing to increasing medical costs and insurance premiums.

Moreover, the American Lung Association cites $96 billion in medical expenses related to smoking in 2004, while a recent article noted $190 billion in annual medical expenses related to obesity.

Beyond personal lifestyle factors resulting in avoidable medical procedures (and expenses), there is also the increase in medical malpractice lawsuits to consider.

A December 2011 article published in the Yale Journal of Medicine and Law notes an 88.2 percent increase from 1991 to 2011 in the average damages awarded to plaintiffs in medical negligence cases, and stated that “the total amount of damages paid by American physicians increased from $2.2 billion to $4.45 billion” – despite the fact that the number of malpractice suits declined over this period.

So, unhealthy lifestyles lead to avoidable medical procedures resulting in increased insurance costs, while malpractice suits lead to increased expenses for medical practitioners (often in the form of liability insurance) resulting in increased medical costs.

One could conclude that health insurance costs have increased due to rising medical costs, which have increased due to unhealthy lifestyle practices and malpractice lawsuits.

To approach health care reform in this manner is to assume, erroneously, that one must peel away the layers until a primary cause is found, which, when fixed, will resolve all other issues. I do not believe this to be the case.

The crisis surrounding health care is far too complex because the components are inextricable. Thus, the solution must be holistic.

A more realistic and encompassing perspective of the factors contributing to the crisis must allow us to work together to find workable solutions.

Much is involved, much is at stake, and we all have a role to play in securing a hopeful, healthy future for us all.

But if we do not acknowledge our contribution to the problem and choose to work together to address the health care crisis, the situation will continue to grow more perilous while everyone points accusing fingers at one another.

Zach Dawes is an ordained minister who lives in Austin, Texas, having served churches in Georgia and North Carolina. He blogs here.

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