About all you can conclude from all the discussion and attention being paid to healthcare reform is that it is a hot topic, one that politicians believe will resonate with the public.
Presidential candidates, gearing up for the long haul for 2008, are highlighting healthcare reform platforms. Hillary Rodham Clinton, believing that the time is right, said in Iowa that she’ll have a plan for universal healthcare. John Edwards has a DVD promoting his approach. Barack Obama embraces the concept of reforming the system.
Of course, simply uttering the word “reform” doesn’t make it happen – not by a long shot. In the last 20 years there have been several attempts, including the legendary 1988 attempt to expand Medicare to cover catastrophic illnesses, which drew the ire of senior citizens. Congressman Dan Rostenkowski’s car was chased down a Chicago street by angry senior citizens, the AARP (which endorsed the proposal) took a huge black eye, and the law was rescinded within a year.
In the 1990s, the Clintons undertook significant reorganization of healthcare, with a massive bill introduced in September 1993. After nearly a year of widespread Congressional committee involvement, Congress managed to pass a watered-down bill that didn’t achieve much.
That was back when healthcare spending was hovering at about $1 trillion a year – you know, the good old days. U.S. spending on healthcare is approaching $2 trillion this year, and experts estimate the tab will reach $2.9 trillion by 2009 and possibly $4 trillion by 2015.
That’s an incredible burden for the nation to carry. And with the demographics indicating that the increasing number of Medicare beneficiaries could exponentially boost healthcare spending after 2015, it’s obvious that the crisis needs solving, and now.
Healthcare’s role in increasing the national debt is being highlighted by David M. Walker, who heads the General Accountability Office. He has toured colleges, spoken to lawmakers and gone to nearly 20 states in the last year, focusing on states hosting presidential primaries.
His goal? Forcing candidates to detail what they’d do to address the national debt.
Quick, what’s your guess for the current federal debt? A trillion bucks? Two trillion? That’s what I had guessed. Talk about living in the past – that’s what it was in 1986. The GAO estimates the federal debt at $8.51 trillion in 2006, and says the debt could reach $50 trillion in the next 20 years because of the way Social Security, Medicare and Medicaid are structured.
Walker believes reform of healthcare and Social Security are the most important steps to take to rein in the debt.
The stars may be aligning for healthcare reform, but political ideologies that polarize decision-makers have stalled reform for years and threaten to do so again. President Bush’s administration sees a different solution than those being espoused by any of the Democratic candidates or the Democratic Congress.
Which ideology is correct is probably no longer the issue. The worst-case scenario is not that the approach selected will be completely wrong – it’s that differing philosophies will counterbalance each other and thwart any meaningful reform over the next two years.
It now looks like states have a better chance to achieve reform. Massachusetts, Illinois and Colorado are moving ahead with healthcare initiatives to try to do something – anything – to improve efficiency, cover more people and cut costs. The perception is that the federal government is moribund and no longer credible in being able to reform healthcare.
It’s sad. Forty years ago, with focused resolve, this country was able to marshal its resources to put a man on the moon with no more computing power than I now carry with me daily on my commute to work. It’s a national disgrace that we all see the healthcare crisis looming before us – eight years and counting to $4 trillion in annual healthcare expenditures – and we’re totally disunited in our ability to answer the warning sirens.