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PD EDITORIAL: The price of health
Cost containment must come before universal coverage
Published: Sunday, August 2, 2009 at 4:00 p.m.
Last Modified: Friday, July 31, 2009 at 4:08 p.m.
The most familiar line of the Hippocratic Oath almost certainly is, “Above all, do no harm.”
Those words, believed to have been written in the fourth century B.C., come from a pledge to practice medicine ethically. They also should be the guiding principle for President Obama and Congress as they overhaul the nation’s health care system.
That said, doing nothing isn’t an option.
This patient is terminally ill, and the disease is contagious. The symptoms are spotty coverage, rising costs and declining quality.
More than 45 million people have no health insurance, and the number is rising. One result is premature deaths. The National Institute of Medicine estimates that 18,000 people die annually as a direct result of being uninsured.
No other industrialized country has so many people lacking health coverage.
Yet, because of skyrocketing costs and an aging population, health care now accounts for one-sixth of the U.S. economy. S
That’s not sustainable.
As for claims that the United States has the best health care system in the world, frankly, that’s hogwash. Here are just a few grim facts: The average life expectancy in the United States is three years less than Canada and four less than Switzerland and Australia, Americans are more likely to suffer from chronic diseases such as diabetes and less likely to receive preventive care, and the death rate for newborns is the highest among industrialized nations.
That’s nothing to brag about.
However, as Congress and the Obama administration have struggled with how to improve the system, it’s become increasingly clear that all of these problems can’t be fixed at once.
Their emphasis has been universal coverage.
That’s a laudable goal. Portability could give people greater flexibility to change jobs and eliminate one of the repercussions of losing a job, as millions have in the current recession.
It also would address the great shell game of our current system, which requires hospitals to care for the indigent and uninsured but provides no resources, effectively shifting the cost to insured patients.
Unfortunately, budget analysts have determined that the universal coverage plans put forth so far would add hundreds of billions of dollars to the federal deficit. Like health care’s growing claim on the economy, that, too, is unsustainable.
With agreement lacking on mandates for employers or individuals to buy insurance, on taxes to pay for universal care or the need for a Medicare-style public option, universal coverage may need to wait until effective methods are devised to contain costs.
Cost-containment itself is controversial, with loud objections to such proposals as restricting physician ownership of hospitals and collecting and analyzing data to determine the most effective approaches to medical treatment.
But the issue must be confronted, and we will comment on various approaches to containing cost and expanding access as health care reform legislation advances in Congress.
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