Shields: On health care reform

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(HOST) Commentator Geoff Shields has been listening to the health care debate and observes that it seeks to address two separate – and possibly incompatible – goals.

(SHIELDS) The great health care reform debate of 2009 has taken an interesting turn.  It is clear that two issues should be addressed in the new legislation.  The first is to extend coverage to the approximately 20% of Americans who currently do not have health care coverage.  The second is to dramatically cut health care costs so that the United States is aligned with Western Europe, Canada, and Japan, which spend about 40% less than we do per capita for health care.
The legislation which is now making its way through Congress does very little to control costs.  On the other hand, both the Senate and House bills do a great deal to move toward the goal of universal coverage.
One might ask, what happened to address coverage, quite effectively while failing quite miserably with regard to cutting costs.  The answer lies in the Administration’s tactics.  The strategy that was adopted by the Obama Administration was to exchange a "seat at the table" to interest groups that were willing to sign on with a vague promise of cost savings.  So the pharmaceutical industry, the insurance industry, the hospital industry, doctors, and AARP all stepped up with grandiose claims that they would adopt measures to save tens of billions of dollars in health care costs.  It is now clear that what they were getting in addition to a "seat at the table" was the promise of greatly increased government spending on health care which would more than offset any "cuts" and ultimately lead to much bigger net revenues for each of these interests groups.
Thus, the independent Congressional Budget Office in its analysis of the House Bill has reached the conclusion that the costs to the American taxpayers of the House proposal will be in excess of $1 trillion dollars over the next ten years.

So, what do we do as interested citizens and taxpayers in advising our legislators on whether we are enthusiastic about what is taking shape? 

While broader coverage is crucial, it seems to me that we should also insist that the cost of the final bill comes down.  To be competitive as a nation, we must bring the cost of health care in line with that in Western Europe and Japan – after all those countries have lower infant mortality rates, longer life expectancy, and better recovery rates for cancer and heart disease.  If they can deliver universal health care and better results at 60% of what it costs in the U.S. our legislative proposals should be able to do the same.

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