These are not separate issues, and I am frustrated every morning when I check the Post or the news outlets online and see the same mischaracterizations repeated again and again. CNN’s Ed Henry says, for example, “The president is facing competing pressures from liberal Democrats who are demanding that he not abandon the push for a major overhaul of health care in favor of a scaled-back bill and conservative Democrats who have said the Massachusetts special election was a wake-up call that should force Obama to put a much heavier focus on job creation.” But in my view, health care and the economy simply are not mutually exclusive issues, and any eventual improvements to either cannot be approached independently with any real hope of success.
James Carville said on ABC's "Good Morning America" that President Obama hasn't done a good enough job explaining to the American people "a coherent strategy" for fixing the economy and creating jobs. He’s right. Americans think of health care and job creation as two competing focal points for the administration, and it’s time the president made it clear to everyone that we won’t really fix the economy, in the long term, if we can’t get control of our health care costs. Does this mean a government-run national health care system? Not necessarily. I don’t think there is only one solution, and I am no proponent of some overnight nationalization program. But let’s face it, this looming problem has been with us for years and no one has done a thing about it. In fact, the 2003 prescription drug bill made the problem much worse – much more acute, yet many in congress simply wish to derail the whole process of reform. I find it very difficult to put confidence in those who shout criticisms from their pinnacles of inaction.
David Walker, former comptroller general of the United States, has been making the rounds in Washington delivering a sobering message on health care and our bleak economic future for years. Insiders have indicated to me, however, that this president is one of the first who’s really listening. Walker says "It's the number one fiscal challenge for the federal government, it's the number one fiscal challenge for state governments and it's the number one competitive challenge for American business. We're gonna have to dramatically and fundamentally reform our health care system in installments over the next 20 years.” What would happen in 2040 if nothing changes? "If nothing changes, the federal government's not gonna be able to do much more than pay interest on the mounting debt and some entitlement benefits. It won't have money left for anything else - national defense, homeland security, education, you name it," warns Walker.
Now let me be clear (I love this phrase): we must approach health care reform in this country with a vigilant eye toward greater efficiencies and more cost reductions, not just expanding access. I believe we as a nation, given our disproportionate spending versus other developed nations, can cover more people, more effectively, and at a lower cost. Today, the way we care for patients is simply wrong. They are just transactions, reimbursed by the drink, and administered in an archaic and expensive manner. Once out of bed, they’re off the radar screen. But institutionalized follow-up care, phone check-ins by an RN after hospital discharge, old fashioned doctor home-visits and local clinics… these can all reduce emergency room admissions and re-admissions once patient problems become acute, which are enormous cost-drivers of our current system. Further, many of our health care companies have been around for generations, and anyone who has worked in corporate America for the last twenty years can tell you that such massive companies are slow to modernize, have large clerical staffs that do outdated and unnecessary jobs, don’t share information well internally as silos have become iron-clad, and retain entrenched employees & managers who refuse to abandon practices that are maddeningly inefficient. My wife and I get a piece of mail that is an “explanation of benefits”, which is practically in another language, and then a second piece of snail mail that is an “explanation of benefits” plus a paper check. First, why isn’t this email? Second, why send it twice? And third, why a check – why not an electronic transfer? How much are they spending to annoy us with all that unnecessary paper? I’d think seriously about firing anyone who proposed such an arcane methodology today. Little start-ups would never put in place a process like that… but then again, they can’t afford to!
So how does health care reform impact the economy? We’ll count the ways:
1) Controlling health care costs reduces our unfunded national liabilities, allowing us to spend our money on all the other things we need.
2) More effective coverage programs and methodologies lead to healthier people. And healthier people will cost less, work longer, and produce more.
3) Companies that spend less on health care are able to spend more on improving plant, equipment, and human capital. This all means better products and services, which results in increasing market share and rising exports.
4) I could go on and on but you get the picture.
So why hasn’t anyone done anything about health care? Kent Conrad of North Dakota is the chairman of the Senate Budget Committee, and he lays it out pretty well. "Because it's always easier not to. 'Cause it's always easier to defer, to kick the can down the road to avoid making choices. You know, you get in trouble in politics when you make choices," says Senator Conrad. But isn’t delaying the tough choices what Americans seem to do best these days? We’ve done it with our personal finances, our infrastructure, our childrens' health problems, and their vapid culture (I feel another rant coming on).
I’ll end with this: we Americans need to quit yelling about the fact that jobs didn’t just reappear five minutes after we had a global financial train wreck, and we need to quit being so myopic about our fiscal and health care problems, and instead think about how much more painful and destructive these issues will be in 10 or 20 years if we do not make the choices we know we must eventually make, and just go ahead make them now. It’s only going to get worse.
p.s. thank you Baby Boomers. I liked the music, but you could have just stopped there…
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