Health-care reform is more urgent than ever
By John A. Ameriks, MD Health policy analyst
Las Cruces Sun-News
The U.S. population will rise above 300 million this year, and health care expenditures are projected to exceed $2.1 trillion. Simple arithmetic leads to the alarming realization that the price of health care in 2006 will be $7,000 for each American. Yet the Senate has failed to take up health reform and our governor vetoed funding for a similar effort in New Mexico.
Few will see the entire $7,000 taken from personal savings or paychecks. The more fortunate and healthy half of the population have small medical expenses in any given year, a circumstance that helps to insulate them from the “up close and personal” experience of health-care sticker shock. And historically only 20 percent of the population is sick enough to use 80 percent of the money, while the sickest 1 percent account for 22 percent of all expenses in the average year. The odds are that you and I are not likely to fall into the 20 percent or 1 percent this year; but the lifetime odds are that eventually we will.
So how do we respond to a problem that absorbs 16 percent of the dollars spent in our country and will demand 20 percent of the gross domestic product by 2015? The suggestions to be heard on the campaign trail will include personal choice, individual responsibility, health savings accounts and consumer-directed plans. Yet none of these provide sufficiently for the costs incurred by us when illness expenses overwhelm our personal economic resources. Simply put, the politically opportune solutions aren’t applicable.
Reforming health care is a troubling prospect. The only group unquestionably in favor is the 16 percent uninsured segment of the population. The remaining 84 percent with current access to insurance view reform with anxiety. They fear losing their existing level of protection or increasing the cost of what they presently have. And they remain unaware that a stealth version of insurance reform is already occurring by the introduction of higher deductibles, increased co-pays, limits on employer contributions and restrictions on provider choice. Yes, even those insured are gradually, and in many cases unknowingly, becoming underinsured. The discomforting truth is that most of us have already lost this game; but few have yet experienced the pain.
This is an election year, and voters have increasing reason to demand meaningful health care reform. We should not be diverted from that demand by the delaying tactic of promises to reform health care once the candidate discovers a uniquely American way to do it. Profound change of our health-care system is not only inevitable but desirable. We do not suffer from distinctly American diseases that require strictly American treatments. While there is no perfect health-care system on this planet, the systems in France, Japan, Germany and the Scandinavian countries are cheaper, provide universal coverage and result in easier access and better outcomes. These are the same countries whose automobiles and electronics appear to be cheaper, better built and more fuel efficient than the domestic choices. We can learn from them. The United States stands alone in not providing health care to all its citizens; and because of that policy, America is finally encountering economic disadvantage in world markets. Without change, this will remain our fate. Our market-based approach has failed to deliver on its promises to provide higher quality at lower cost.
Health-care reform makes greater economic and common sense than ever. It need not cost more than we are already spending; and reform of the entire system offers the only realistic path to future cost containment. In a world with open borders and global economic competition the involvement of elected officials in this issue is unavoidable and even desirable. Under these circumstances the public has every right to know the candidates’ position on health care. We should not give them a pass in 2006. The lives and dollars we save will be our own.
John Ameriks, a retired physician who lives in Las Cruces, is a health policy analyst for the New Mexico chapter of Physicians for a National Health Program, a national advocacy group.