Why is Health Care so Expensive?

And what can we do about it

Photo by Online Marketing on Unsplash

Here in Europe, we are lucky, we have universal health cover for free in most countries. I hear it’s not the same for you guys at the other side of the pond.

Don’t get me wrong. This is not one of those politically loaded articles about what is wrong with America and why we are better off here. Not at all, but I always wonder what makes healthcare so expensive, why it keeps rising, and what can be done about it. I am particularly interested in what can we as individuals do about it.

How to reduce costs and improve health

I strongly believe that health should not be a business. There is something very wrong about profiteering from people’s sickness. I’m all about free healthcare, however…

If the taxpayer is going to subsidize your health then the government has a right to demand that you take care of yourself. That is a personal responsibility.

Also, those who do the damage, Tobacco industry, oil industry, and junk food industry mainly, should pay the cost of the disease they create. That is corporate responsibility.

Via negativa

It’s cheaper and more effective to prevent people from smoking rather than spend money on cancer treatments. This is known as via negativa, a term coined by Taleb in his book The Black Swan.

If we can’t forbid smoking then the tobacco companies should pay for the damage they have caused. Simple as that.

And the same goes for the Oil industry and Junk food industry.

The indirect costs

Any company selling stuff should pay for the hidden costs they are causing to the population.


• Pollution generated by oil products are responsible for the deaths of 4.5 million people a year worldwide and generate a health cost of $8 billion daily

• Tobacco causes 7 million deaths a year worldwide and costs $1.4 trillion a year

• The health costs of unhealthy food kills millions and costs trillions

Here is a simple solution:

• Make companies pay for the damage they generate

• They’ll be forced to clean their act of go bankrupt

• Make individuals that engage unhealthy habits pay for their own healthcare

And voila! Healthcare costs will plummet while health will dramatically improve.

If it’s so easy why is nobody doing it?

Most governments don’t have the guts to do anything like this. They are kept hostage by the big corporations and big pharma on one hand and they don’t want to lose votes from the addicted population either.

Is this ethical?

It’s all about responsibility, we’ve been treated paternalistically for too long and that is not good for society.

There is of course the argument that poor people can’t afford healthy food and uneducated people can’t understand the consequences of bad habits.

But that’s just not true.

There is plenty of healthy cheap food so, if the government tax unhealthy stuff heavily, problem solved. Also non-smoking and non-drinking surely is cheaper than the opposite.

Using big brother

This a bit controversial but, how about measuring the health of an individual and their physical activity with a smartwatch?

These devices keep getting better and soon they’ll be able to measure everything — blood pressure, sugar levels, cholesterol, heart rate, etc — in real-time and give accurate advice on demand.

Those who follow the recommendations can benefit from lower insurance premiums or get free health cover.

These devices could, for example, prompt you to exercise when your sugar levels are high or eat something healthy when these are low. It can give dietary advice according to your needs or advice to rest when you have overdone it. I have a Garmin watch that tracks my activity and I’m pretty sure that my health has improved thanks to it, also it makes sure that I don’t overdo it.

Now, if you keep everything under control you’ll become healthier and your health bill will be lower. Health should be free for you even if you have a genetic predisposition to certain illnesses. But if you have been naughty (smoke, drink, junk food, no exercise) you should pay a hefty premium.

I know it sounds like a dystopia, but the system we have now is clearly not working and this could improve it dramatically. Of course this should be controlled by the government in a fair and transparent way.

The problem with big pharma

There is plenty of evidence with Big Pharma inflating the prices, creating addiction, and blocking competition.

In the US they spend 30 million a year lobbying and that includes the FDA.

The latest scandal is the opioid crisis in which several companies have been accused of getting the nation hooked on painkillers and causing 130 deaths a day.

Here is where the government should step in and regulate Big Pharma, put a cap on profits, and promote the use of generics. This combined with a healthier population can reduce the healthcare bill by trillions.

In conclusion

Don’t rely too much on the government or big pharma. You know how to be healthy, do it and you’ll increase your quality of life while saving millions.


Get the Medium app
