It's time to reform the nation's health care delivery system,
analysts of almost every political hue now agree. Moreover, they
say, piece-meal or stop-gap measures won't prevent a disaster.
The system has been lurching toward ruin for years and may get
worse before reforms can take hold.
"It will happen by the end of the decade," predicts political
economist Uwe Reinhardt of Princeton University. "But first we will
really have some dark days. Our system is like a sick man who
knows he is sick but doesn't want to go to the doctor because he
fears what he might find out."
Reinhardt, who often has been consulted on the economics of
health care by administrations and congressional leaders alike, says
everyone agrees that the system is failing, yet "almost nobody wants
to sit down and figure out what we need to do."
A report issued by the conservative Heritage Foundation cautions
against the temptation to add new programs to a system described as
"Because of its fundamental flaws, the gaps in the existing
health care system can never be closed at acceptable cost without
structural changes," wrote Heritage's Stuart Butler and Edmund F.
Among the more obvious flaws:
- Too many people are excluded from the system, and the costs
simply are pricing others out of the market.
By most estimates, roughly 37 million people are without health
insurance. In that group are some 22 million working poor and 15
million who are unemployed. Still others, perhaps as many as 15
million, are said to be underinsured.
Oklahoma's uninsured number from 600,000 to 800,000 employed
workers. Despite a growing consensus that change is both essential
and inevitable, a clash of ideas is a virtual certainty when experts
and elected leaders start talking about the methods of financing
This year the nation's total health care bill will exceed $600
billion - approximately 12 percent of gross national product - with
costs rising at an annual rate of 7 percent.
As the national government ponders its endless gusher of red
ink, the allure of mandated care, thereby forcing employers and
their employees to shoulder the entire financial burden of health
care, has won over a small but vocal band in Congress. Sen. Edward
M. Kennedy, D-Mass., has introduced legislation calling for mandated
care, guaranteeing basic health coverage for everyone. But his bill
is not expected to reach the floor this year.
Earlier in the year, the Bipartisan Commission on Comprehensive
Health Care, also known as the Pepper Commission in honor of the
late Rep. Claude Pepper, D-Fla., though divided chiefly along party
lines, recommended an $86 billion per year national health insurance
plan which also would include long-term care.
Underscoring the difficulty of finding agreement on financing
mechanisms, the commission, headed by Sen. Jay Rockefeller, D-W.
Va., was unable to advance any method to pay for such a plan. The
report now gathers dust in the archives.
The ultimate irony is that so many people in and out of
government know the sick and failing components of the health care
delivery system. Perhaps no one alone has all the answers, but
together they have the expertise to make the system work, even if
that entails a remodeling of the structure. …