"Unless I'm totally daft, one of the most effective ways to limit healthcare costs is to limit wages and salaries. Herein lies the fears of reduced quality of helthcare, and the tremendous resistance (by those receiving those salaries) to do so. "
Toggles, I have to disagree with you here. I have worked in the medical field, both human and animal, for over 22 years. I have no problem with doctors, nurses, and other health care personnel being well compensated. Just as I don't mind engineers, architects, and other professionals making big salaries. They went to school, often for many years, to get their expertise. If they are good at what they do, then they have the potential to earn a large salary, and thus will continue to strive for excellence in their chosen field as well as attract other people into that field to carry on in the future. (As an aside, I still think the great thing about America is that you don't have to get a college education to prosper or even "make it big" in business.)
While some doctors, notably specialists, make big salaries, one significant part of the high costs of health care is the result of malpractice insurance and the fear of being sued. Because of malpractice fears, most doctors and hospitals tend to run more diagnostic tests than may be required for a given situation. There have been cases where people have died during routine procedures and even though basic lab work was run, lawsuits have been filed claiming that "if the doctor would have done this test and that test, this patient wouldn't have died." The result is a lot of tests being run that might not be useful or necessary for a certain patient. Lets face it, no matter how simple a procedure is, no matter how much lab work is run, no matter how skilled the medical staff is, someone somewhere is going to die during the procedure due to a hidden condition or for unexplained reasons. Every person's body is different in its sensitivities. The doctor and hospital might be cleared in court (if the case is not settled out of court), but they still have to pay the legal costs for their defense. Or rather, their malpractice insurance has to pay. Malpractice premiums can be outrageous depending on a doctor's specialty.
I know that malpractice issues are only one part of the problem (and my dialogue above is overly simplistic), but it is a significant part. There needs to be quite a bit of reform in this industry, including insurance and legal reforms.
Also, drugs are pretty expensive. It can cost over $500 million to develop a drug and get it approved by the FDA. The FDA has stringent guidelines for proving the safety and efficacy of a drug and it costs a lot of money to research and test a drug to prove that it is safe and efficacious. Drug patents last about 20 years, after that point cheaper generics can become available. I don't have an answer for decreasing the costs associated with drug approval without compromising safety.
