Revered health care economist Victor Fuchs has said that America will never achieve serious health care reform until there is a depression, a war or civil unrest.
Well, we’ve pretty much hit the trifecta in 2008, and it’s an election year no less. We might just be staring at the best opportunity in generations to overhaul our cockamamie health care system.
That’s the conclusion of Dr. Ezekiel Emanuel, Chair of the Department of Bioethics at the National Institutes of Health, whose editorial on the subject appeared in last week’s Chicago Tribune.
Emanuel argues that people are desperately concerned about financial security, and to achieve that we must control health care costs. As for businesses, things have gotten so bad lately that that tens of thousands of them, big and small, will be wiped out if they can’t off most or all these costs, and soon.
And whether Republicans like it or not, a new era of interventionist government has arrived. In fact thanks to recent (and necessary) interventions by a Republican administration, you and I now own US banks. We own insurance companies. We own mortgage lenders like Fannie and Freddie, and we may soon own housing securities.
Now to be sure, even the most radical single-payer plans do not suggest that the US government should own health care in the same way. No one proposes that we employ physicians or that we own hospitals, drug stores and pharmaceutical companies, so let’s knock-off the scurrilous, fear-mongering rumors that comprehensive health care reform means socialized medicine.
In one day a few weeks ago, US politicians committed $700 billion to shore up the banking system. It would take about a third as much to overhaul the US health system so that it covers everyone while delivering a higher level of quality than it does now. The upfront spending would include IT platforms and quality measurement systems that position us to save hundreds of billions of dollars down the road while continuously and forever improving health system performance.
Has anyone proposed legislation that could do this? Actually, yes. The Healthy Americans Act (S. 334), also known as the Wyden-Bennett health care bill has bipartisan support and is awaiting action by the Senate Finance Committee. It calls for more sweeping changes than the plans proposed by either candidate for president.
Wyden-Bennet happens to be the only legislative alternative that the Congressional Budget Office says is budget neutral, and that’s in year one. After that, the proposal saves money. The Lewin Group is on record saying that within a decade it could save $1.4 trillion. The candidates’ plans increase health spending.
And the raw politics are that the constituencies of both parties find health care investment to be more palatable than bailing out Wall Street. Think big, fellas.