Monday, March 15, 2010

So, so close...

According to data recently released by the Centers for Medicare and Medicaid Services (CMS), health care spending rose last year by 1.1 percentage points, to 17.3 percent of the gross domestic product (GDP).  That marks the single largest increase in any year since 1960.  The reasons cited include the economic recession and resulting rising unemployment, plus the aging of boomers into Medicare.  Average public spending growth rates for hospital, physician and other clinical services, and prescription drugs are expected to exceed private spending growth over the next four years.

By every measure, we are spending a greater and greater proportion of our resources on health care.  With unlimited means, we might conclude that that is a worthy pursuit given better health outcomes and improved quality of life for patients over the past several generations.  But resources are not unlimited and policymakers are right to worry that inaction could result in eventual disaster.  And with public spending exceeding private spending, the pendulum is shifting toward a government (i.e., taxpayer funded) health care system regardless of whether we describe what's happening as "government takeover" or "public option" or "socialized medicine" or not.

Politics aside, the President and his party are taking the position that doing something is better than doing nothing.  Opponents argue that doing nothing is better than accepting the current reform proposal.  The latter group have the easier task because they are able to scare the citizenry with images of second class European-style government run hospitals and conjure up feelings of fear by asking whether we trust our health to "the same people" who brought us the Registry of Motor Vehicles or the Post Office?  Proponents have the harder task because they ask us to envision a world with and without comprehensive health reform.

If the President ultimately loses this battle, it will be because he failed to fully paint a picture depicting what inaction could do to us.  He has not convincingly argued what will happen if health care tops 20 percent or 25 percent or even 30 percent of the GDP.

We may be in the final days of this historic battle.  And this could be as close as we ever get.

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