Why Does Basic Health Care Cost So Much In The U.S.?

Many of us have gone to a hospital for an emergency or just a routine check up, but are soon discouraged from returning because of the shocking price tag. I, myself, had an unsavory bill a couple of months ago from a visit to the ER. Because the hospital wasn't covered by my insurance, I had to find a way to pay around $9,000 for some IV meds, an Xray, and for a bored doctor to poke around my throat. With the Affordable Care Act coming into effect next year, there's a growing interest in finding out how much basic health care costs and why Americans are paying so much for so little. The answer is, well... complicated, so I'm only going to hit some low points.

First, I'd like to address the unfounded belief that the U.S. is paying more because of the obesity epidemic and our other unhealthy behaviors. America, in fact, has a lower prevalence of smokers and drinkers than most European countries, and even if that wasn't true, an increased prevalence of disease doesn't equal an increased price for the treatment.  Though we do have an obesity problem, our inflated bodies shouldn't account our inflated fees.

Source: Centers of Medicare and Medicaid Services

However, the bill, when we finally receive it, has been delegated and added to so much that the price we pay is fairly arbitrary. Costs for therapies and tests not only vary between states, but between facilities and patients. The difference isn't really even related to the quality of care either. Patients given an IV(a bag of sterile salt water thats production cost is kept secret but has been said to be less than a cup of coffee), a procedure with minimal physician interaction, can expect a wildly varying bill costing hundreds of dollars. 

Basically hospitals and clinics charge whatever they think that they can get away with. Sure, insurance companies try to haggle price down, but many times they don't have much bargaining power, because if the hospital is unmovable in its opinion the insurance company can just transfer the costs down to the patient by raising premiums. The patients have even less of a chance to lower their bill. There isn't a tidy menu with therapies and their prices on display so most doctors will choose to give their patients pricey, yet unnecessary, tests and drugs even if there are cheaper and equally effective alternatives available.

Now, in my opinion, how we fix these problems:

• Government regulation: Most countries with lower health costs have some way of keeping tabs on drug and therapy pricing, but in the U.S. we like to consider the health industry a free market. This usually keeps prices down through competition, but, when patients are uninformed, hospitals, pharmaceutical companies, and other health facilities are free to raise their prices without their customers realizing that there are other options. 
• A menu: I know it sounds ridiculous, but, once prices are set, if there were menus above each department displaying the prices for common procedures, I suspect that hospitals would have to make their bills honest. (In my mind this conversation would happen if menus were in hospitals. "Could I have this gunshot wound patched up?" "Would you like a drink with that?" "No, liquids go right through me." *Ba dum tish*
• An addendum to "informed consent": If doctors were more forward with their patients and mentioned the alternatives to the expensive test they were about to order I think most patients would choose the cheaper option if it had similar effects. 
• Education: As in everything, don't trust me or any other uncredited source. Get out there and read some articles! The New York Times, the Vlogbrothers, and many others have talked about this. My blog entry is just a stub, because I have so little time to dedicate to this to this huge topic. There is plenty of information out there if you look for it. 
• I don't know... Immortality: If we were somehow impervious to harm or disease we wouldn't need health care, would we? 

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The People Behind The Curtain: Ernest Rutherford

"For Mike's sake, Soddy! Don't call it transmutation. They'll have our heads off as alchemists."

-- Ernest Rutherford

 If there had to be one scientist I could choose to be my grandpa, it would be Ernest Rutherford. He has just the right ratio of quirk to genius, and, with eleven protégés becoming Nobel Prize winners themselves, I'd say he would be the perfect man to teach me about life.

Look at that glorious mustache! 

Ernest Rutherford was born 1871 in New Zealand  and was raised on a flax farm where he didn't get his first taste of academia until, at the age of ten, he received a textbook that he read and reread. He eventually went on to Nelson and Canterbury Colleges, and, in order to work on early radio wave technology, he moved to England to do his postdoctorate at Cambridge. After becoming knighted for developing ways to better detect submarines, he became the director of the University of Manchester's physics lab.

However, Rutherford did not quite fit in with the stuffy scientists in England. He was utterly ridiculous. As a lab director he sported a dense walrus mustache, walked around campus carrying radioactive elements in his coat pockets, and reliably smelled like the cigars and pipe tobacco he smoked. On top of that, he shouted bizarre euphemisms ("For Mikes's sake") instead of swearing, which he would often do at his lab equipment if they wouldn't cooperate, and sang "Onward, Christian Soldiers" loudly, without reason, and usually off pitch. Once, Rutherford even remarked that he "felt like an ass in lion's skin," because, as a boisterous farm boy, he couldn't relate with his reserved colleagues.

Despite (or, perhaps, because of) his abrasive and hilarious personality, Rutherford would end up doing his most influential work with nuclear physics there. I am going to explain three of his most popular experiments: where he discovered that radioactive elements transform as they decay (Radium => Radon), where he proved the existence of radioactive alpha particles released from decay and that they are actually the gas helium (Two Glass Bulbs), and his most famous work, where he proved the existence of a small but dense positively charged nucleus (Gold Foil).

Radium => Radon Experiment

After Marie and Pierre Curie's work with radioactivity in the late 1800's, it was understood that radiation spread outward from a radioactive element. Many people thought that it was spread by a gas of some sort, similar to the idea of an "ether" that most doctors earlier in the century believed spread illness before the germ theory was developed. Rutherford set out to find out what kind of gas was being released and spreading the radiation.

To do this he and his partner, Fredrick Soddy, placed a sample of radium in a container full of water and collected the gas from the bubbles forming on its surface. They were thrilled when they found out that the bubbles were a new element, radon. And not only had the two scientists discovered a new box on the periodic table, but they noticed that as the amount of radon they gathered increased, the original sample of radium decreased. Ergo, radium had actually transformed into radon! Rutherford had discovered radioactive decay, and how unstable substances jump across the periodic table as they change.

Two Glass Bulbs Experiment

Helium gas being excited by electricity. This would
have been the same glow that Rutherford saw when he
ran a current through the alpha particles.

Rutherford noticed that even though elements decay, they don't decay in the obvious way by moving one place to the left on the periodic table, loosing a single atomic mass unit. Elements jump two spaces to the left, loosing two electrons as opposed to one. Rutherford named the packets of two electrons shot out of the decaying element alpha particles. Alpha particles, having two electrons and two protons, were actually single helium atoms breaking out of the large unstable element.

To prove this, Rutherford made two glass bulbs: one small and bubble thin, and one larger and thicker. He pumped radioactive gas into the small bulb which he placed in the larger bulb, and waited. The alpha particles had enough energy and were small enough to tunnel through the first glass but were stopped by the larger glass. To show that the invisible gas trapped between the bulbs was the helium alpha particles, Rutherford excited them with an electrical current and the bulb glowed the customary helium purplish color. (If you've ever seen neon lights, you'll know the glow).

Golden Foil Experiment

Or instead of reading this section, you could just watch
this .gif... 

Though Rutherford is known for this experiment it is important to note that his colleagues, Hans Geiger and Ernest Marsden, are the scientists that carried it out, even though his work made it possible. Rutherford just presented the idea and published it.

Previously, the established idea for the structure of the atom was the "plum pudding model", the thought that the atom was a positively charged mass with free-floating electrons meandering about inside like the raisins in plum pudding. Though Geiger, Marsden, and Rutherford doubted this, because they believed that there was a small positively charged nucleus that the negatively charged electrons were orbiting, much like planets around the sun (or pedophiles around an elementary school... whatever).

The scientists set up an experiment where a decaying element would shoot alpha particles into gold foil. After hitting the foil the alpha particles mostly passed through the atoms unscathed, but some veered off a few degrees as if being deflected. If the plum pudding model was correct then no particles should have been deflected because the atom would have been mostly empty space, but by measuring the angles at which the alpha particles were deflected Geiger and Marsden figured that there was a center, a nucleus, that the particles were bouncing off of.

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Works Cited

"Ernest Rutherford - Biographical." Ernest Rutherford - Biographical. 19 Aug. 2013 <http://www.nobelprize.org/nobel_prizes/chemistry/laureates/1908/rutherford-bio.html>.

"The Gold Foil Experiment." The Gold Foil Experiment. 19 Aug. 2013 <http://myweb.usf.edu/~mhight/goldfoil.html>.

Kean, Sam. The disappearing spoon: And other true tales of madness, love, and the history of the world from the periodic table of the element. New York: Little, Brown and Company, 2010.

"Legacies- Ernest Rutherford." ThinkQuest. Oracle Foundation. 19 Aug. 2013 <http://library.thinkquest.org/07aug/00458/erutheford.html>

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