Creating New Health Conditions is Costly

Medicalization is a term used to describe the taking of certain problems and defining them as medical issues.  Some examples over time include menopause, alcoholism, attention deficit disorder, infertility, anxiety and sleep disorders.  Most of these conditions were originally not viewed as medical problems requiring health attention.  A recent article attempts to quantify the costs associated with this process of medicalization.   (Social Science Article)

The authors identified 12 conditions that had been medicalized since 1950 and for which they could obtain reasonable estimates of related health spending.  The conditions include anxiety disorders, behavioral disorders, body image services (cosmetic), erectile dysfunction, infertility, baldness, sadness, obesity and substance-related disorders.  They estimated that direct spending on these conditions in 2005 was $77 billion.  While that is relatively small part of total spending, it is still a lot and is more than was spent for heart disease or cancer.

No one would argue that most of the medicalized conditions do not in some way relate to good functioning of a human being, which broadly defined is the aim of health care.  In many cases, medical treatment can improve the deficient functioning.  But much of this medicalization is driven by drug companies and providers, particularly psychiatrists and psychologists, who are trying to increase their revenue opportunities.  In the course of doing so, they cause unnecessary anxiety among consumers about whether or not they have serious health problems.  Maybe we can medicalize that anxiety and treat it!

The real underlying issue is what kind of conditions should properly be covered by a benefit plan, particularly one which is funded by the taxpayers.  Every time one of these new diagnoses or conditions is created, there is corresponding pressure to force health plans, including Medicare and Medicaid, to pay for it.  There are all manner of mandated benefit laws for these conditions, adding to insurance costs.  Drug companies, providers and patient advocacy groups make large political contributions and do a lot of lobbying to ensure that they can get paid by health plans.  This is an area that should be carefully examined if we truly want to control the increasing portion of health insurance premiums paid by consumers.  Only covering really necessary services would lower costs for everyone.