Weighing in on Health Care Reform

We do need health care reform.  The question is what kind of reform do we need.  Unfortunately, partisan politics has led us to this point where we are focusing on narrow issues, such as the “Public Option” and loosing sight of the big picture.

Let’s start by looking at the cold hard facts about our health care system.  We currently spend an average of approximately $7,300 per US resident, per year on health care.  That is double that of any other country in the world.  So are we getting double the results?  The answer is no.  Two of the key health indices used to measure the health of a population are infant mortality and life expectancy.  We are 43^rd from the lowest infant mortality rates in the world.  A child born in Hong Kong, Cuba or Slovenia has a greater chance of survival than one born in the US.  We are 47^th in the world in life expectancy at 78.14 years.

Even more frightening, is the rate at which health care costs are increasing and the fact that our health care indices are all the while dropping, relative to the other major industrialized nations.  In the six years from 2000 to 2006, health care costs rose by 87% and we continue to experience double digit inflation.  In 1960, we had the 12^th lowest infant mortality rates in the world.  In 1990, we had the 21^st lowest infant mortality rates in the world and today we are 43^rd.  Clearly, we are going in the wrong direction.

The other very important statistic to note is that there are approximately $46 Million Americans who have no health care insurance.  Of those, 9 Million are children.  When these people need health care, they will eventually get it, when they are sick enough to go to the hospital ER, where they can not be refused care.  This is the highest cost setting and we are all paying for it through our taxes, through our health insurance premiums, through our out-of-pocket fees and in the price we pay for goods and services from companies who pay health insurance premiums.

People who say that we have the best system in the world are deluding themselves.  We will have the best system when our people are the healthiest, when we all have access to health care (at least those who wish to) and when we are paying a reasonable price for what we are getting.

For health care reform to be effective, it must deal with the many complex reasons behind the high costs and less than stellar results.  It would not hurt to start by taking a look at those systems that are producing better results at half the cost per capita.  We also must be aware of the fact that there are stakeholders in this process, who are profiting nicely from the status quo.  It is worth their investment in mounting significant political opposition to any proposal which will upset that status quo. 

Prominent and respected members of the U.S. Congress, Such as John McCain and Orrin Hatch have commented on the impact of the passing of the late Sen. Edward Kennedy, by saying that it will be more difficult to pass a reform bill without his skill at negotiating compromise.  Interestingly, Senator Kennedy had been working on health care reform since he came into the Senate in 1962.  I heard him speak in both Chicago and Washington, D.C. back in 1978 and he was pushing strongly then for Universal Health Care, citing many of the arguments above but with less dramatic numbers.  Well financed interest groups were the problem back then, as they are now.  We can not use Senator Kennedy’s death as an excuse for lack of progress.

We also can not afford to hastily push through an ill-conceived reform bill, just for the sake of declaring a political victory.  The issues are too complex and the stakes are too high.  The people voting on the bill and their constituents must understand what they are voting on and the broad implications. 

There are many experts who study, compare and contrast health care delivery systems across the world, whose knowledge and expertise can be relied upon for rational input to a healthy debate.  If we can stop the shouting and the irrational fear and ignorance based arguing and get to an intelligent discussion, that would be a good place to start.  Let’s take it down a notch and proceed with caution but also with a serious intent to make real improvement to an overly expensive and inefficient system of health care.