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American Health Care – Broken and Unsustainable

The American health care system is broken and unsustainable.  Our national government reports that over 16 per cent of our nation GDP goes to health care expenditures.  This is double our competitor nations in Europe and Asia.  All measures of the health of our citizens have concluded we lag the other 37 rich countries by far.  We spend more, get less and the cost trend is not sustainable.  One side effect is that education expenditures in our schools and colleges are being sacrificed to maintain health care programs. America can not hope to maintain its global economic leadership and standard of living if we continue to let our education investment slip.

Crisis, but why no Action?

Health care is not a typical crisis.  Costs slowly creep up and we adjust as the flood waters rise.  Mostly Americans are insulated from the full brunt of rising costs. Employers pickup 70-90% of the costs insulating us from reality. The burdens are spread unequally with one out of six Americans without coverage, but the other five out of six are covered just fine. Employers have suffered economically, but have found ways to shift costs to employees, outsource jobs or hold wages down.  Americans have not drawn the connection between wage stagnation and health care inflation – its hidden.

The latest trend is new company start up that tend to not offer health insurance to their employees.  Medicare has survived by paying doctors less than their costs – another form of cost shifting to other consumers of health care services.

Is the Pain Great Enough?

There are signs that the pain has grown to the extent that a broad coalition can be formed to support comprehensive national health care reform.  Many health care providers – doctors and nurses – see the faults of the health care system growing and have joined the ranks of reformers. Employers are starting to wake up to the fact that the current system is not sustainable. Unions are re-examining their historical support for employment based health care and realizing system change may be needed.   More and more voters are finding they are underinsured, are tired of fighting insurance companies and see continued cost shifts to their checkbook.

Health care has been greatly elevated in the 2008 Presidential campaign as a consequence of the continued erosion and decline of our health system and the pressure from the growing reform voice.

But, the challenges facing health system change are monumental:

  • National Health Expenditures at 16% are three times the size of all military expenditures
  • 10 % of the work forces is dependent on health expenditures
  • Politically the hurdle of 60 US Senator supporting reform requires a bi-partisan support
  • The lobby groups opposing health system change are massive, well healed and politically embedded in the campaign donation and lobby system that continues to dominate outcomes in our Capitol
  • Only a small portion of business leaders and lobby groups have concluded health care must be fixed, let alone found any consensus on the form “reform” would take
  • The new President and Congress face other competing crisis – Recession, Crippling energy costs and no consensus on long-term energy policy, Financial and liquidity problems that continue to crop up casting doubt on whether a “solution” is in place and wars in Iraq and Afghanistan to cope with.
  • Bush era deficits reduce the options for the next President and Congress