Everyone is now intimately familiar with the concept of an economic bubble. Current finanical markets, housing prices, and the Dot-com bubble easily spring to mind. But bubbles don't necessarily need to be limited to stocks or real estate. Wikipedia defines an economic bubble as "trade in high prices that are considerably at variance with intrinsic values."
Health care doesn't fit the traditional mold. While companies in the industry have been profitable, we haven't seen the speculative wave of investment typically thought of in most bubble scenarios. After all, it was pretty difficult to miss the housing boom. Health care has sucked up an ever increasing amount of resources, which people realize intellectually, but unless you've recently received a hospital tab that's not getting picked up by the government or your health insurer, it's difficult to have a real appreciation for.
Health care spending in the US last year was well over 2 trillion dollars, providing 14 plus million jobs and accounting for about 15.2% of our GDP. Debates have raged over how much value were getting for our money.
The US systems does some things very well. It leads the world in technology and innovation. Cancer treatment is without equal. It also gets hammered in WHO and Commonwealth Fund rankings. While there is much to take issue with in these rankings (things like their interpretation of infant mortality statistics defies belief), no one would argue that there is probably a diminishing return with increased health care spending in terms of outcomes.
Above is a chart measures productivity life expectancy improvement per dollars spent. That may be a poor surrogate...a number of other contributing factors such as worsening diets and diminished exercise. On the other hand, I could give you a list a mile long of high priced interventions that marginally improve outcomes and few people would pay for if they were picking up the entire tab.
I think health care has avoided the knife thus far, largely because a majority of payment for health care services has been hidden from view. Employers and the government pick up a large portion of the cost, which are seen as payroll deductions, but aren't as noticeable as copay's or annual deductibles.
As of now, we've been able to have our cake and eat it too. Tech advancement coupled with economic prosperity have set high standards of care in the mind of the population. Lack of access to the latest cancer treatments, MRI's for back pain, elective orthopedic surgeries for elderly arthritics is unacceptable in the mind of most people. As significant as these advances are, the modest improvement in outcomes may not be enough to justify their high cost and widespread use.
Perhaps a proper analogy of our system is that of a luxury car. It has a lot of bells and whistles, but you can still probably get from point A to B without them. The difficult truth is economics and demographic dictate our current level of resources will not be available for much longer. Americans may decide that they are no longing able or willing to continue current levels of spending. Heath care certainly has the government's attention, though it is still unclear what their exact strategy of dealing with it is.
What ever happens, be it government rationing or more efficient free market choice of services, the industry as a whole should be prepared to shed some weight. The vision of job security in health care may be about to be shattered.