Rx for Health Care: Pain (We need candid debate about health care but the odds are against it)

Washington Post ^ | 6 December 2007 | Robert J. Samuelson

[shrinkermd]

...Everyone believes in adequate health care; people should have it when needed. Politicians cater to these beliefs. But the intellectual and even moral laziness of this approach results in an invisible abdication of political responsibility. We are letting the unchecked rise in health spending determine national priorities. Consider:

• Health spending already totals more than $2 trillion annually, about 16 percent of national income (gross domestic product). By 2030, it could easily exceed 25 percent -- one dollar out of four -- projects the Congressional Budget Office.

• There's a massive transfer of income from young to old. Americans 65 and older now represent about an eighth of the population and account for about a third of all health spending. By 2030, their population share will be about a fifth, and they could account for nearly half of health spending

• Neither the government nor the private sector has succeeded in controlling health spending. From 1970 to 2005, average spending per Medicare beneficiary rose 8.9 percent a year. For similar services, spending for Americans with private health insurance rose 9.8 percent annually over the same period. The small difference may reflect cost shifting. When Medicare imposes price controls, doctors and hospitals increase prices for privately insured patients.

Questions arise. How much will health spending increase taxes, depress take-home pay and crowd out other government spending -- on schools, roads, parks, defense?

The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care. Workers with employer-provided insurance believe that their companies pay. Retirees and the poor think that the government, through Medicare (retirees) and Medicaid (the poor), pays. No one has an interest in controlling spending, because everyone believes that it burdens someone else.

[shrinkermd]

Excellent take on the problems with little in the way of solutions. Hard to excerpt and I focused on the problems he listed.

[Wonder Warthog]

"No one has an interest in controlling spending, because everyone believes that it burdens someone else."

"Don't tax you, don't tax me, tax that fellow behind that tree" Russell Long (D) former Senator from Louisiana (now deceased).

The one time a Democrat told the truth.

[cinives]

Neither the government nor the private sector has succeeded in controlling health spending.

Nor should they. If people were exposed to the costs of their health care, they'd control it themselves.

The best fix ? Allow full deductibility of health insurance in the tax code, push high deductible/HSA insurance, rein in trial lawyer lawsuits, allow people to buy the health insurance coverage they think they want instead of having it mandated by the state, allow lower level medical workers - nurses, physician assistants, etc - to offer first-line care for colds, ear infections and the like, and allow primary care clinics to open at will.

After few years of seeing those results, then we can see what's what. Until the market is allowed to work, we can't get a handle around this beast.

[goodnesswins]

GET the GOVERNMENT out of HEALTH CARE!!!! That Middle Man costs a LOT!

[socialismisinsidious]

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