House is one of my favorite TV programs. But, in the interests of drama, it skips completely over any economic questions relating to health care. Start with costs: House's team of one genius and four dunderheads probably costs the hospital a total of some $2 million a year in salaries. But I suspect that Lisa Cuddy, the hospital administrator, keeps the team on for another reason besides her latent lust for the scruffy crippled doctor. That team probably generates huge profits for Princeton-Plainsboro hospital. They order up expensive tests like McDonald's milkshakes. Your heart surgery failed? We'll do brain surgery next. That didn't work? We'll try something else. Oh, you had some simple thing that one injection makes disappear in minutes? Well, so it goes — you're cured. Does your insurance cover all this? No one ever asks.
Hospitals are businesses. Even the non-profit ones have to make money to survive. To make money they need filled beds, busy ORs, and bustling test facilities. This is not to say that hospitals don't want us to get better, it's just that the financial incentives strongly tilt the table towards more income-generating events. The rest of the health care delivery system is in the same boat. It is this tilt of the table that must be addressed if we are ever to be successful in reducing health costs. The private marketplace is not the solution to this problem. Society, in the form of government, must have a leading role.