Inexorably rising costs
The Battle Over Health Care
The New York Times
Editorial
September 23, 2007
In 2008, when it comes to health care, which is emerging as a defining domestic issue, voters will find stark differences in philosophy and commitment between Democrats and Republicans.
The three leading Democratic candidates all want to achieve universal or near universal health insurance coverage. The four leading Republican candidates espouse no such goal and barely mention the uninsured. The Democrats are willing to put substantial federal money into health care reform. The Republicans are not. The Democrats would expand government health insurance programs and give the federal government a greater role in regulating the insurance industry. The Republicans generally want to shrink federal programs and free the insurance industry from what they consider regulatory shackles.
Compared with these sharp differences between the two parties, the distinctions between leading candidates within each party are small, mostly a matter of tactics to achieve comparable goals. We far prefer the Democrats’ approach to health insurance, since at least they want to address an issue that must be resolved for reasons of economics, public health and fairness. Sadly, none of the leading candidates, in either party, has the vision or the political courage to propose radical solutions for the big underlying problem behind America’s health care crisis: the inexorably rising costs.
http://www.nytimes.com/2007/09/23/opinion/23sun1.html?ref=opinion&pagewanted=all
Health Coverage in the Balance
The New York Times
September 25, 2007
To the Editor:
Re “The Battle Over Health Care” (editorial, Sept. 23):
As long as we continue to build on our current fragmented system of financing health care through a multitude of private plans and public programs, we will never get a handle on rising health care costs.
The administrative efficiencies of a single national health insurance program would free up enough funds to pay for care for the uninsured and under-insured. But reducing administrative waste alone is not enough.
With our own national health program we could improve incentives that would reinforce our rapidly deteriorating primary care infrastructure. Providing everyone with access to a primary care medical home has been demonstrated to slow cost increases while improving quality.
Appropriate specialized high-tech services certainly provide value, but such care very often is overused, resulting in no benefit while driving up costs. A trusted primary care practitioner can provide each of us with advice on those services that actually would be of benefit.
Don McCanne, M.D.
Senior Health Policy Fellow
Physicians for a National Health Program
San Juan Capistrano, Calif.
Sept. 23, 2007
http://www.nytimes.com/2007/09/25/opinion/l25health.html
Comment:
By Don McCanne, MD
Providing health care coverage for everyone and making health care affordable are two different issues, though they are both problems that are inversely related to income.
Covering everyone is the easy problem. As in every other industrialized nation, the legislators merely need to establish public policies that would accomplish that goal. In spite of the rhetoric about controlling costs, the three leading Democratic candidates have focused primarily on this one issue, though their proposals would fall short even on this goal.
Controlling costs is quite another matter. The average premium for employer-sponsored family health insurance now exceeds $12,000. With a median household income now at $48,000, these numbers no longer work. Health care costs have risen to a level that makes it impossible for private insurers to market products with reasonably comprehensive benefits that have premiums that are still affordable for average-income families.
Furthermore, private insurers control health care financing for a majority of us, but they have had no significant impact on controlling health care costs (except for a blip in the curve when they instituted private sector price controls). Leaving the private plans in charge can only result in a continued failure to slow the growth of health care costs.
A single payer national health program would accomplish both goals. It would automatically cover everyone, and it would put into place mechanisms that would slow the rate of growth in health care spending while actually increasing value in our health care purchases. Reinforcing our primary care infrastructure, as mentioned in the letter above, is one of the more important measures, though the single payer model includes several other mechanisms that are also important.
The candidates hear and understand our message, but they remain timid. Why? Because we have failed to enlist enough support of the roughly 35 percent or so of Americans who are healthy and have what they believe, on blind faith, to be adequate private insurance coverage. They are beginning to understand their vulnerability, but we have much more work to do to educate them. And we must do it now, while the window is open.