EDITORIALS
Move health reforms
This is the time to find a way to repair an unsustainable system
It may be too much to say that anything would be an improvement, but health care as it exists in this country is a dysfunctional mess. As plans take shape to reform it and critics begin to pick them apart—and all will contain flaws —it will be important to remember this foundational fact: The status quo is killing us.
The nation needs to find something better—something that will offer all Americans health care while reducing the unsustainable growth in costs. That is the process now under way in Washington, one that President Obama wants to see completed this year. The deadline is tight, but given the nature of American politics, understandable.
The problems with health care are well documented. Millions lack insurance. Their employers may not offer it or they may have lost their jobs, possibly because they were ill. Costs are escalating to the point that before long $20 of every $100 will be spent on health care—far more than any other Western country. Medical costs are the No. 1 cause of bankruptcy in the United States. And for all that, our outcomes are generally mediocre.
Meanwhile, Americans live as though there were no consequences to abusing their bodies. Too many of us are obese, eating too much that is bad for us. We don’t exercise. We bring on ill health, further raising the public costs of medical care. It can’t go on. We are driving ourselves to an early grave with a brief stop at the poorhouse.
Americans voted overwhelmingly for Democrats last year in part because of worries about health care. Obama and congressional leaders are pushing hard for a bill that makes good on their pledge. In just the past week, the Senate health committee approved a $600 billion bill to expand health care, and House Democrats announced a $1.5 trillion plan that would cover 37 million Americans over the next decade in part by imposing a new tax on the 2.1 million wealthiest Americans. Both are good starts. Both need debate.
Some arguments against reforming health care are disingenuous. Some, for example, claim that federal involvement will lead to rationing of health care. But health care is rationed now. Millions go without it because they have no insurance. Why don’t the critics mention that?
Other objections are more serious and deserve attention. Costs of comprehensive reform begin at around $1 trillion over 10 years. That’s a huge amount of money, but the price tag needs to be measured against the costs of inaction— which carries its own huge price by leading to more expensive public and private health care costs down the road— and other options.
One thing is certain: What we are doing now isn’t working and changing it won’t be free. This is the time to fix this problem. Democrats are the only ones interested in doing it, and now is when they have the power to act.
To be sure, Democrats need to expand their approach. In particular, they need to show some enthusiasm for restraining the peculiarly American lawsuit culture that is driving medical malpractice rates through the roof and doctors out of business. Other countries, including Canada and Great Britain, that better control malpractice litigation have fewer problems with escalating costs and fleeing physicians.
This is the most significant domestic matter that Congress has taken up in years. Representatives need to treat it carefully and respectfully, but with a clear understanding of the need and the opportunity. It’s time to act.
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