According to Bloomberg, Standard and Poor's has indicated a negative outlook for U.K.'s credit rating. Historically, U.K., United States, and other leading nations have held AAA credit ratings which is the highest possible rating. The announcement of Standard and Poor's outlook is of particular interest to me because I remember that several months ago, U.K.'s central bank lowered its target interest rate to the lowest since the 1600s. Its near-zero rate raised the issue of what would happen if it didn't work (the U.S. near-zero rate raises the same question). The connection between the target inerest rate and the credit rating is this: governments acheive their target interest rates by buying their own bonds (in the U.S. the Federal Reserve Bank purchases Treasuries on the open market as well as directly from the Treasury). Two observations can be made from this process: 1) The government is borrowing more money (A LOT more during this crisis) 2) This process can also be thought of as "printing money" - that is, the money the Treasury borrows didn't really exist before it sold bonds (and paid them off). When you print money, you inflate the money supply, which causes devaluation pressure, and possibly lowers your credit rating.
The relevance for medicine is that in the U.S. government spends (depending on the year) close to half of all money spent on health care. One might be tempted to think devaluation of the dollar won't really affect health care so much then because government won't be willing to pay dollars to compensate for the fact that the dollar is worth less, and then people working in health care will just have to take what the government gives them. Actually, they won't. If people working in health care get paid less and less because of a devalued dollar, they will find other places to work where the pay can better help them survive. One can imagine what would happen to the state of health care then.
On the other hand, if health care spending becomes more federal and the government just prints more and more money to put into health care and other sectors the cycle continues until the government can't print money fast enough to keep up (I suppose eventually people would just value the dollar so much less than say, a Canadian dollar, that people would tend to work in fields where they can get paid in Canadian dollars.) In that case, for the most part the U.S. government would no longer be able to finance health care as we know it - instead it would be financing a backwards and possibly unsafe health care system where only a fortunate few will have anything resembling reasonable access to the decreasing numbers of physicians and facilities. If you don't "believe in inflation" and its ill effects consider the extreme example of Zimbabwe which was recently calculated at a 231 million percent inflation rate. I don't think we'll see that rate any time soon but inflation doesn't have to get to that point before most of us suffer its effects.
So what's the solution? It depends on who you are, and it depends what kind of time frame you're talking about. If you're at a good job with good coverage you might not need a solution right now. If you don't have coverage you might try to find a way to get covered and stay covered by a government program (although if you're an "average" adult male you might find this is impossible). If you are interested in medicine as an innovator, researcher, or developer - the world needs you - we need you to find a way to do an "end-run" around the system - kind of like the way fax and e-mail did an end-run around the post office.
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