Why not take your medicine?

When you can’t breathe, you tend to go to the doctor to find out why. But surprisingly, though inhaled (cortico)steroids (ICS) are very helpful in most varieties of lung disease–and according to one doctor, can prevent 90% of deaths from asthma–nearly a quarter of patients who are prescribed ICS don’t even get the prescription filled and barely a third of those who get them actually use them (you’ll need to sign up to read the full article).

My mother suffered for years with breathing difficulties–first with COPD (chronic obstructive pulmonary disease), then later the diagnosis was changed to emphysema. Having watched her fight for her quality of life for more than a decade, I’m surprised to hear that people don’t use their medication when they have it. and for those who don’t even get the prescription filled, I have to wonder.

When I remember what the head of University Hospitals said about health care costs (here), I have to wonder how much the structure of our health care funding has to do with these strange statistics. If you don’t have to pay for your own medications, you might be inclined to take them for granted and discount their value–like some kids who are handed a college education as if it were a right and then fool around and get crappy grades because the true value of it is not clear to them. And if you get a prescription but don’t get it filled, maybe you just don’t have much faith in your doctor (or in medications), or you might be one of the millions who don’t have good insurance and can’t afford to pay for regular prescriptions.

Of course, the human factor–people behave unpredictably because they’re all motivated by different things–inevitably complicates attempts to make a health care system work. But while most systems have flaws, the U.S. health care funding situation is pretty sad. One entrepreneur said he wrote a check to the hospital and doctor for the birth of his first baby in Singapore, and now he’s still paying the bills years later for the birth of his second child in the U.S.

It might make sense for all the insurance entities to study the lessons of the Outback Steakhouse story I told in my newsletter this week. Who knows what might develop? Email me if you didn’t get a copy and I’ll send it along.