The Cost of Delay

One option available in the health reform debate, one that those who argue "keep your hands off my healthcare" seem to support, is to do nothing about healthcare.  After all, "we have the greatest healthcare system in the world!"  In 2005 we had the second most expensive healthcare system in the world (after the Marshall Islands when measured as a percentage of Gross Domestic Product consumed by healthcare), but only the 37th best healthcare system according to the World Health Organization.  That puts us just behind Costa Rica, and just ahead of Slovenia.  We die sooner and live less healthy and productive lives than citizens of many countries around the world.

Want to spend $500 billion less on healthcare than we do today?  Roll the clock back to 1993 and pass President Clinton's healthcare proposal.  Want to save $1 trillion on healthcare this year?  Set your time machine to 1974, and pass President Nixon's healthcare reform proposal.  The graphs at the end of this post illustrate what happened because we did nothing.  Denial and delay has cost us trillions!

In the "What Might Have Been" graph below, note the blue line (the median national healthcare expenses as a percentage of Gross Domestic Product (GDP) of 30 industrialized countries, and the red one showing the U. S.'s share of healthcare expenditures as a percentage of GDP.  The difference between the two lines illustrates a key reason U. S.  employers' are losing competitive advantage with businesses in other industrialized countries.  Is it any wonder that we manufacture less, than we used to?  Our healthcare costs make our entire country uncompetitive.  

U. S. healthcare spending is soaring far higher than a number of other nations, making our employers, who finance much of this spending, less competitive.  This link provides graphs which show the U. S. breaking away both in percentage of GDP devoted to healthcare, and also health care expenditures per capita, two categories in which I'd prefer we didn't lead.

The bottom graph shows the growing burden of health costs on family budgets.  In 1999, we spent 11% of family income for health premiums.  By 2007 it had increased almost 64 percent to consume 18 percent of family income.  By 2020, it is projected health premiums will consume 24 percent of family income.  

The cost of doing nothing is very expensive.  It is the one option we simply can't afford.

(Click to enlarge graphs)

Step by Step

Republicans want to take health reform step, by step.  See where that will get us in Joe Heller's cartoon below.

Prescription Pricing

In one more sign that health reform legislation is not a government takeover of healthcare, the legislation which has passed the House and Senate, or which is proposed by President Obama, does not allow re-importation of drugs from other countries which negotiate drug prices with pharmaceutical manufacturers.  Neither does it allow price negotiation with pharmaceutical manufacturers. A senior White House adviser, David Axelrod, was quoted as saying the White House would push for legislation to allow re-importation of pharmaceuticals in separate legislation, after the health reform bill is passed.

Take this bill and reconcile it!

Republicans are not interested in supporting health reform.  The healthcare summit indicated they want to start over.  On issue after issue, it was pointed out that ideas that had been championed by Republicans were included in the bills which have passed the House or Senate, but still Republicans wouldn't vote for ideas they profess to support.  

I am reminded of the proposed Gregg-Conrad deficit reduction commission in the Senate, which was endorsed by President Obama, shortly before the bill was voted upon.  The bill was sponsored by Senators of both parties.  Sponsors included Republican Sensators, Sam Brownback (Kan.), Mike Crapo (Idaho), John Ensign (Nev.), Kay Bailey Hutchison (Texas), James Inhofe (Okla.) Lisa Murkowski (Alaska) and John McCain (Ariz.), none of  whom voted for the bill they co-sponsored.  (Lisa Murkowski was away from the Senate for a family matter, and didn't vote.)  That's just nuts! 

Start Over?

The Republican mantra at today's healthcare summit seemed to be, "we need to start over."  After 12 months of discussion on the national stage, after hearings before five Congressional committees, after thousands of letters, emails and editorials, why would anyone think it was a good idea to start over?  If Republicans are serious about helping to solve this problem, it will be relatively easy to amend current bills.  Amendments will be necessary to reconcile differences between the House and Senate versions of health reform legislation, so incorporating some changes to win Republican votes would be easy if Republican votes were really there.  In reality, they are not there.

The urgency for starting over is nothing but an attempt to avoid doing anything on health reform.  It is a vote for the status quo, and that is clearly unacceptable.  In seven to 10 years, healthcare costs will double again, we'll be spending $25,000 or more for a family policy, businesses will be driven out of business if they provide insurance or the uninsured population will surge if businesses drop health coverage, all businesses that offer health coverage will be increasingly uncompetitive with competitors in other countries where government provides this vital service, and costs are far less than they are in the U. S.