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We can’t go on like this



Published: Fri, September 11, 2009 @ 12:00 a.m.

We can’t go on like this

There’s been a lot of talk about options this summer as the future of the health-care industry in the United States was debated — much of the time in a civil fashion, but too often in unproductive, uncivil terms.

But of all the options facing the nation, there’s only one thing that isn’t an option, and that would be doing nothing.

Democrats, Republicans, Independents, Libertarians, Socialists and anything in between can argue about the best and worst approaches, and there is, somewhere in that hodgepodge, a perfect answer and an awful answer. But the worst answer is a system that continues to expand in cost at a rate much higher than inflation, at a rate much higher than disposable income and at a rate that has already made the United States the big spender for health care among all its peers.

The nation now spends $17 out of every $100 for health care, and for that we get uneven results. Those who can afford the best — either from out of pocket or through Cadillac-level insurance plans — get the best. Those less fortunate get lesser levels of care and, too often, financial ruin in the bargain. In a weak economy, struggling companies are increasingly hard-pressed to provide the health-care coverage their employees had become used to. Meanwhile, the increasing copayments that those companies must pass on are cutting into family budgets.

Looking close to home

This reality can be plainly seen in Pennsylvania and Ohio. Recently a nonpartisan health care advocacy group, Families USA, released a report showing that as we approach the end of the first decade of the 21st century, health care premiums in Pennsylvania increased 95 percent, from $6,721 in 2000 to $13,116 in 2009. During that same time, median earnings of workers in the state rose from $24,834 to $29,188, an increase of 17 percent. That means health insurance premiums rose more than five times faster than median earnings.

Families USA will be releasing its report on Ohio next week. The figures haven’t been revealed, but a teaser released to the press indicates that the numbers are even worse for Ohio. The cost of health care premiums have increase more than seven times faster than earnings in Ohio.

In his address to a joint session of Congress Wednesday, President Barack Obama set certain goals for health care and health insurance reform. They would, he said, stabilize costs, provide broader coverage, protect people from being dropped by an insurer when they get sick or be denied coverage because of pre-existing conditions. And, he said, this could be done without adding to the national debt.

Time to go to work

That is a tall order, and it will be up to the president and his supporters — almost all Democrats at this time — to show how that can be done. At the same time, it will be up to Republicans to provide their alternatives with the same kind of specificity.

That’s not going to be easy for either side, but the challenge may be greater for Republicans. One of their solutions is tort reform, which its advocates say will eliminate outrageous jury awards in malpractice cases, and thereby reduce unnecessary tests ordered by lawsuit-wary doctors and cut malpractice insurance rates. But more than 20 states, including Ohio, have enacted tort reform, and the promised benefits have not materialized. Certainly the United States is a more litigious nation than most others, but Americans are not spending 17 percent of GDP on health care while the Swiss spend 12 percent because of lawsuit abuse.

There are some who apparently believe that the most important thing is to defeat any serious reform, to maintain the status quo, with nothing more than a cosmetic change here or there. If that happens, those who win today will have to answer in the years ahead, as increasing health care costs continue to put unsustainable burdens on companies that strain to provide health-care coverage and on families forced to cut more corners in order to pay medical bills.

The political stakes are enormous for the parties. The implications for Americans, especially the middle class, are even larger.


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