How the Health Care Beast is Gobbling Up America

Even more than a public option, if Obama could truly reduce costs, that would make insurance affordable for more people. I think a lot of people latched onto the public option as the saving grace of reform. Maybe it is. But I don't believe that reform without a public option is a complete FAIL as others do. There are plenty of other aspects of our health care system that need changed.
I wholeheartedly agree with David Brooks, who says health care is eating up money that could go toward other more important things, such as education. And the fee for service structure has got to go:

Several months ago, President Obama made a promise: People with health insurance would be able to keep exactly what they have.

We all understand why he made that promise. He wanted to reassure people who are happy with what they’ve got. He wanted to mollify the industries that have a vested interest in the status quo.

But Obama’s promise sent the reform effort off the rails. It meant that efforts to expand coverage marched ahead, but efforts to fundamentally reform the system got watered down.

Instead of true reform we got a series of bills that essentially cement the present system in place. The proposals do not fundamentally challenge the fee-for-service system. They don’t make Americans more accountable for their own health care spending. They don’t reduce costs. They just add more people into the mess we’ve got.

The president made this promise to ease passage. But it ended up hollowing out the substance of the reform. And the political benefits didn’t even materialize. Voters are still spooked by the costs, the centralization and the cuts they are sure will come.

If I had a magic hour with the president, I’d tell him this is his ninth-inning chance. He can stay on the current path. He might be able to pass some incremental bill that extends coverage. But he won’t have tackled the fundamental problems that first drove him to this issue. He won’t have cut health care inflation. He won’t have prevented a voracious system from bankrupting the nation, defunding the schools, pushing down wages and impoverishing the young. NYT

Brooks recommends this story in the Atlantic, and it is indeed a good read:

I’m a businessman, and in no sense a health-care expert. But the persistence of bad industry practices—from long lines at the doctor’s office to ever-rising prices to astonishing numbers of preventable deaths—seems beyond all normal logic, and must have an underlying cause. There needs to be a business reason why an industry, year in and year out, would be able to get away with poor customer service, unaffordable prices, and uneven results—a reason my father and so many others are unnecessarily killed.

The spending:

Yet spending on health care, by families and by the government, is crowding out spending on almost everything else. As a nation, we now spend almost 18 percent of our GDP on health care. In 1966, Medicare and Medicaid made up 1 percent of total government spending; now that figure is 20 percent, and quickly rising. Already, the federal government spends eight times as much on health care as it does on education, 12 times what it spends on food aid to children and families, 30 times what it spends on law enforcement, 78 times what it spends on land management and conservation, 87 times the spending on water supply, and 830 times the spending on energy conservation. Education, public safety, environment, infrastructure—all other public priorities are being slowly devoured by the health-care beast.

More:

I’m a Democrat, and have long been concerned about America’s lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system—largely problems of incentives—our reforms won’t do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government’s role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy. Read the whole thing I say! One of the best stories yet on health reform.