Doc Jesuit

The drive for health care reform, which seemed like a slam dunk back in February, has the Obama Administration scrambling to salvage some kind of bill, with or without the so-called "public option."

Much of the debate has centered around the uninsured and the strain they put on the system. Mark Aita, S.J., M.D., a bioethicist and assistant director of the Institute for Catholic Bioethics at Saint Joseph's University in Philadelphia, says the problem isn't that people have too little insurance, but too much.

"Most Americans are blessed with too much health insurance, and we do not use it wisely," said Aita. "Many expect the most expensive treatments, but the costliest treatments aren't always necessary. We blithely say, 'My insurance will pay for it' without realizing that, in the end, we all pay."

Aita, a trained physician and Jesuit priest, says the insured have an ethical responsibility to maintain or improve their own health, which in turn, will help control costs.

"While it is impossible to implement a program forcing people to live healthy lifestyles, it is reasonable to assume that healthier living leads to lower costs," he said.

Over the last few decades, medical science has delivered miracle drugs and advanced technology that saves, and extends lives. While these technologies are important, Aita says they can also drive costs if they are used when they aren't really needed.

"Health care economists say the control of technology is the most important factor in bringing costs down. They estimate between 40 and 50 percent of annual cost increases can be traced to new technologies or the intensified use of old ones," Aita said.

But controlling health care costs -- especially those associated with technology -- is easier said than done. There simply isn't any interested party in the health care debate arguing for less use. Quite the contrary.

"The problem is that patients expect high-tech care. Physicians are trained to use it, medical industries make billions selling it, and the media loves to write about it," Aita said. "Technological innovation is as fundamental a feature of American medicine as it is the industrial sector, and there is fierce opposition to any limitation in the use of medical technology."

Effective controls would force patients to forgo treatments they do not need, doctors to sacrifice to a considerable extent, their ancient tradition of treating patients as they see fit, and industry to reduce its drive for profit. Aita says these constituencies are all that's required to maintain the status quo.

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