Thursday, July 15, 2004

Healthcare Reform: A Huge Problem

David Broder in the WaPo has an op-ed on just what we're facing when we talk about healthcare reform:

The United States spends almost 15 percent of its income on health care, far more than other advanced countries. That's about $5,540 a year for every man, woman and child.

Costs are rising four times as fast as wages. One informed estimate places the cost of employer-sponsored health care coverage for the average family at $14,500 in 2006, just two years from now.

The Census Bureau found last year that almost 44 million Americans had gone without health insurance for the previous year. That number has been increasing by roughly 2 million a year. Families USA, a consumer group, says that almost 82 million people, one out of three below age 65, were uninsured at some point during 2002-03, most of them for at least nine months.

Frist also talked about the "inefficiency" of the system, noting that "according to a recent Rand study, patients received recommended care about only half the time for conditions such as my own specialty of heart disease, as well as diabetes."

But there is worse, he said: An estimated 98,000 people die each year from medical errors. Death rates for heart disease are twice as high for African Americans as for whites.

It is a backward industry. Hospitals and doctors invest 50 percent less a year in information technology than retail establishments or the travel industry. Your credit card goes with you, but your medical records -- on paper -- remain buried in some physician's or hospital's files, inaccessible to any other provider if you get sick away from home.

If all of this suggests the need for a massive overhaul, that is exactly the impression Frist wants to leave. And he is far from alone.

Next week the National Coalition on Health Care, a nonpartisan group billing itself as the largest and most broadly representative alliance of organizations supporting health care reform, will outline what it thinks is needed -- changes that it says "go far beyond any proposal now being considered."

Its president, Henry Simmons, a physician, testified to the Democratic platform committee last month and said exactly what Frist said: "The main point I want to leave with you," Simmons said, "is that the crisis we face cannot be resolved by our present strategies or with the patchwork efforts of the past. Neither can it be resolved by dealing with only one or several of the problems we face. Resolution will require comprehensive health system reform."

That means dealing simultaneously with the problems of the uninsured, of cost controls, of uneven quality and of lagging technology. It will require government action, in cooperation with business, the medical establishment and patients themselves. It will be expensive, but private economists and government budget experts testify that without these needed reforms, pension systems, corporate balance sheets and federal budgets all face near-certain disaster in coming decades.

I know that some will say that Bill Frist is a ass-kissing toadying and incompetent Senate leader. I would agree. He even let himself get sandbagged by the Democrats on the Senate vote on the anti-gay-marriage ammendment. However is also a physician and familiar with the details of the medical establishment and some of its problems. He may be a weak politician and a pawn of political forces in his party, but in this case he happens to be right. It is a problem. That's why it's a disaster that we are going to be so strapped that we may not have the simple financial wherewithal in order to successfully tackle the problem in the next few years. It's gonna be tight.


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