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Last updated: Sat, Aug 24, 2024
Pain has a considerable cost in modern societies. The Mayo Clinic in 2001 reported that each year about half of Americans visit a physician with the primary complaint of pain.1 Another 2001 study reported that 2.3% of physician visits are caused by pain alone, over 17 million visits per year.2
In an earlier section we looked at the incidence and prevalence of chronic pain (A Brief Epidemiology of Pain). A 2003 study estimated that chronic pain costs the U.S. economy about $100 billion per year. The largest share of that cost was due to reduced performance while working. Although this is only an estimate and can be challenged, it is a large cost even if it is off by half.3
A 2002 study reported that $12.5 billion was spent on just the treatment of arthritis annually in the U.S. This study, too, estimated a large cost in reduced performance because of pain, in this case over $7 billion per year.4
The National Academies of Science and the Institutes of Medicine in 2001 estimated the financial impact of back pain. They included lost productivity, lost wages, lost household services, and social security benefits, and arrived at an estimate of $45 billion to $54 billion per year.5
The National Headache Foundation estimated in 2005 that over 45 million Americans are subject to chronic headaches, at an annual cost of some $50 billion per year, which included absenteeism and medical treatment costs. In addition, over $4 billion a year was spent by these patients on over-the-counter medications.6
Much of this large cost is paid by employers and other taxpayers, and so are a matter for public concern and public decision-making. A well-employed pain sufferer may have the bulk of the costs of his illness absorbed by medical insurance, sick leave, and disability insurance. The less well-employed are likely to carry more of the costs themselves. A large part of the costs become the revenues of medical care providers.
Who is responsible for the costs related to an individual's injury or illness in some common situations depends upon who is deemed legally responsible for the injury or illness and upon its severity. The severity of an illness or injury becomes an important issue in three common situations: 1) injuries and illnesses that were incurred while employed, which are usually handled legally through a state-regulated workers' compensation system; 2) accidental injury, such as injury in an automobile accident; 3) social security disability. With the exception of social security disability, these systems are highly variable across political jurisdictions. In all three, pain is at least an element of severity, so pain can translate into dollars once legal responsbility has been assigned.
All three of these systems are adversarial: employee vs. employer, insurance company vs. insurance company or plaintiff vs. defendant, worker vs. Social Security Administration. In all three cases the petitioner must plead while disabled and suffering. In all three cases, the petitioner is relatively without resources in relation to their adversary. In all three cases the petitioner normally has no viable alternative to pursuing redress through this mechanism. Unless, of course, the petitioner is dissembling or overreaching.