13Previous chapters have outlined why radical changes have to be made, and
will be made, in the health care system, preferably early and calmly, but
more likely late and with much sound and fury and lasting social disruption.
In this chapter I discuss what must be done. I do not attempt to propose how
it should be done. If war is too important to be left to the generals, health
policy is too important to be left to the medical care industry; that is how
we got into our present fix. It took decades to arrive here; it cannot be
What to Do?
What Health System Do We Want?Reining in health care spending is not an end in itself, only a means toward
other ends. So first, what are our goals, what kind of health system do we
want? I propose the following goals:
|1. ||1. Provide universal coverage for health care meeting minimum standards of need and treatment; we are the only advanced nation that
does not do this. Curtailment of spending should not be at the expense
of this goal.|
|2. ||2. Reduce the share of GNP spent on health care. There is no need to
spend twice as large a share of GNP on health care as some advanced
countries with universal coverage and better outcomes in terms of
infant mortality and life expectancy at every age.|
|3. ||3. Reduce the future increase in share of GNP spent on health care.
Some increase is essential to care for an aging population. The effect
of technologies yet to be developed cannot be predicted but can be
influenced. It is unthinkable that within the lifetime of most of us, we
should be devoting one-third of GNP to medical care, which is the
implication of current trends. This goal, together with the second goal,
seeks to preserve growth opportunities for the economy and maintain
and improve people's standards of living.|
Questia, a part of Gale, Cengage Learning. www.questia.com
Book title: Healthy, Wealthy, or Wise?Issues in American Health Care Policy.
Contributors: Charles T. Stewart Jr. - Author.
Publisher: M. E. Sharpe.
Place of publication: Armonk, NY.
Publication year: 1995.
Page number: 223.
This material is protected by copyright and, with the exception of fair use, may
not be further copied, distributed or transmitted in any form or by any means.