Why health care is so expensive

This excellent article from Sunday's NYT magazine shows how the profit motive can lead to medicalization of natural variation and overspending on "health care." It details Eli Lilly's succesful campaign to have its version of human growth hormone approved to treat "idopathic short stature" which is just a fancy way of saying shortness. The drug is expensive ($20K/year x 4-5 years) and minimally effective (final increased height in the range of 1-2 inches). And new research shows being short doesn't lead to any major psych issues.

You would think the clinical virtues of a $2 billion drug would be readily apparent, but just last month, an editorial in a medical journal acknowledged that "uncertainties" about the psychological benefits "may well dampen enthusiasm" among doctors for increasing use.

So while lots of people can't afford insurance, the health care system is paying $50-100K per inch to make kids taller. In a more rational system, where people actually cared about medical costs, either the drug would be a lot cheaper, or used a lot less.

I should note that growth hormone does have a legitimate role in patients with truly medical conditions resulting in short stature like actual deficiency of growth hormone.