First Let’s Get Cost Under Control
Independent of political bent, people who take policy seriously know that it must work structurally, not just ideologically. And universal coverage is very much a structural problem.
We should absolutely establish universal coverage in this country, for reasons I’ll cover in other arguments. But at the same time, we must address the cost of health care.
Consider that we're now spending about $2.6 trillion annually on health care, more than in any other economic sector. And, in the five years from 2002-2007, the cost of health coverage premiums - where costs throughout the continuum of care converge from the health care supply chain, care delivery and finance sectors converge - rose 4.4 times as fast as general inflation and 3.7 times as fast as workers earnings.
Worse, economists know that one-third to one-half of all care and cost is waste, created by slop and misaligned incentives in the current system, and bolstered by a policy arena controlled by special interests.
As Peter Orszag, Director of the Congressional Budget Office told the Senate Finance Committee in June 2007, if we continue to allow Medicare/Medicaid cost to spiral upward as it has over the last 40 years, by 2050 we'll spend the equivalent of the current entire US budget just on those programs!
So going to a universal coverage system without changing the ways we manage health care could be disastrous.
Sign up for the OV Daily Newsletter
OV Social
Lowering National Health Expenditure (NHE) as a % of GDP has to be the foundation of reform. it needs to pave the way for expansion of our social welfare programs. it needs to be an integral part (or vice versa) of making health insurance always accessible and portable. Real leadership would set a target (remember "we'll put a man on the moon in this decade"?). i'd like to see a goal something like: NHE < 15% of GDP by 2016.
Healthcare, not to be confused with health insurance, is made up of a huge marketplace of doctors , nurses , hospitals, device makers, etc. we need market reforms that makes sense, that increases supply and helps check the runaway demand.
we need to avoid policies that support or increase prices. proposed legislation includes both taxes on healthcare and subsidies for insurance that will do both of these bad things. the legislation also discourages programs that tend to increase personal responsibility, like HSA's and such.
for the spirialing costs. The demands they place on providers is unbelievable. I began working for a hospital in MN 11 years ago in patient financial services. We had 20 employees for coding, billing, and collections. Now, we have 89. Most of that is due to the demands governement places on us in order to get a claim paid. The waste is not on the provider end, but on the payer end. Government is the problem, not the solution.