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Health Care Reform: It Can't Happen Soon Enough

09/12/09

Barack Obama's sustained leadership of health care reform is not the product of some dazzling liberal utopian vision.  In stark contrast, he is working to save U.S. and global economic prosperity.  In my lifetime, things can get very ugly.  Let me explain how.

First, consider the soaring costs of health care delivery, caused by our current systems, as shown in Figure 1.

Figure 1: Projected U.S. health care spending, as a percentage of GDP

Congressional Budget Office (CBO) projections of the future U.S. spending on health care

(Figure adapted from the Congressional Budget Office)

One thing is clear from this graph: we can't afford to make it come true.  Our expanding obligations to receive proper care is one of the several unsustainable paths that young people have inherited.  Consider also the rising costs of Social Security; this program is expected to stop working as soon as 2017.  Combined, the costs of health care and Social Security are fueling the problem of our lifetime: the ballooning U.S. budget deficit (Figure 2).

Follow up:

Figure 2: Projected budget deficit of the United States

Courtesy of the Washington Post: Projected Budget Deficit of the United States

(Figure courtesy of the Washington Post)

So what do we do about these problems?

We start by supporting policies that will last for our whole lives -- not just a decade.  We understand how essential health care reform really is, if not only for ethical reasons, then also because of economic necessity.  And we urge the public to support the Obama administration's imminent reform of Social Security, soon after health care legislation has been passed.  Both of these life-support systems must still work, when we need them most.  But we can't expect that unless there are major changes to it.

Of course, we must prudently respect the efficiency of free market solutions.  But we can't risk a free market failure, and that is where this is heading.

In short, if we ignore necessary reforms, then we can expect tomorrow to be awfully less prosperous than today.  If we wait, we can expect to pay more on yesterday's debt, and have less for what we need today.  But Americans do not need to settle with such expectations, because we can act now, and steer our nation far and away from its predicted train wreck.

5 comments

Comment from: Mary Liu [Visitor] Email
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Yes, health care reform is necessary, and all this talk of implementing a public option should translate into action - bills being passed rather than partisan-fueled arguments.

However, let's not insert judgment on free markets and their risk of "failure." The train wreck that America is headed towards was not a result of a free market collapse. The rapid economic decline post-2006 (aka post 02-06 housing bubble) was not from the greedy decisions of mortgage companies. When government dabbles in bank regulation through artificial support of their loans (re: GSE Freddie Mac, Fannie Mae), they effectively INSURE the risky behavior of bank lending. Where a market free of government intervention would compel banks to assess their actions with greater care, now we need more government regulation to fix what it caused in the first place.

The health care situation is just a subsidiary problem and result of the pseudo-capitalist system in place.
09/18/09 @ 09:36
Comment from: Lance Legel [Member] Email
Mary Liu,

Thank you for the sharp critique. You make several strong points, so please welcome a few relevant assertions:

Societies without government regulation can become monopolistic, ecotoxic, and harmful to constituencies -- to start with. Of course, the same could be said, e.g., of a fascist nation. But history has shown (consider the Great Depression) that market-driven systems can be driven to the ground. I assert that our "pseudo-capitalist" system stabilizes and secures our future from such cataclysmic game-changers.

Yes, a Fed-backed insurance program might encourage the decadent culture that created the crisis. But facing crumbling markets, policy makers did what they thought would work. There are still major systemic risks in the ever-pumping financial industry. So, we must dilute these risks. Then, we can endure the failure of a bank -- rather than be destroyed by it.
09/24/09 @ 02:24
Comment from: Carlos Bonilla [Visitor] Email
I find it interesting that you end your defense of the government insurance overhaul program in its current form by saying that we must dilute risks. I guess you forgot that risk cannot be diluted. Especially when considering health care, it is inevitable that people will get sick. The government program is not trying to dilute the risk or even helping manage the risk, it simply wishes to transfer the burden to a larger group of people. In its current form the overhaul will be first and foremost aimed at enlarging the insurance pool by making health insurance mandatory, the goal being to dilute not the risk but to dilute the burden of each individual within the insurance mechanism. A good idea if you think the insurance mechanism is still viable with today’s healthcare system. Unfortunately yesterday’s insurance designed to protect from large losses when dealing with health does not really mesh with today’s preventive medicine, further undermining the initiative is that it will not allow the insurance companies to deny coverage. While I wish everyone could be covered so they can stay healthy the costs associated do not work with the insurance mechanism that can spend up to fifty dollars to get someone a Tylenol. The insurance mechanism works when there are few claims that take from the pool meaning the pool does not need large contributions that become a burden to the participants. The overhaul will succeed in allowing the system to continue working for the short term but it does not take away the underlying problems which cause the rising premium rates and the cost of insurance.
09/29/09 @ 14:04
Comment from: Lance Legel [Member] Email
Carlos,

You raise valid concerns: thank you for expanding my insight and stimulating thought.

Your critique exposes why I think pending legislation will have fixes for the status quo, but will not be sufficient for the secular future. Indeed, the key to cost containment is to prevent the exorbitant fees being pumped from spontaneous trauma treatment. This requires more than an insurance program -- government or private -- it requires healthy living with gradual care.

You are correct to assert that the government program simply dilutes the burden to more people, rather than focusing on the cause of the burden. But keep in mind that this dilution already exists, only more subtly and with greater socioeconomic costs, because major victims without insurance require bankruptcy bail-outs.

I think it is essential that we move the debate to this question: what can government, or private initiatives, do to extensively prevent, rather than insure?

Useful answers to this question will take into consideration the efficiency of free-market solutions, and the respect of individual preferences.
09/29/09 @ 16:52

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