Daniel Weintraub gets it. He’s a long time political writer for the Sacramento Bee. And when it comes to health care reform, he gets it.
In the February 27, 2007 edition (Editorial Section, page B7 — click here to see the article), Weintraub writes, “Any plan that does not seriously address the underlying costs of health care will only move responsibility for those costs from one place to another.”
He goes on to quote the CEO of the California Health Foundation, Mark Smith, who notes, “Much of the discussion about making health care more affordable … assumes that what we are trying to make more affordable is the insurance policy…. But the insurance policy at some point really just pays for the underlying care, and it’s the underlying care which is too expensive.”
In short, it’s the cost of health care which is behind the cost of health insurance. The logical conclusion is that our goal should be health care cost reform. Yet the debate seems mired in reforming health care coverage. And I have to confess to being as guilty as the next guy. The CAHU Healthy Solutions plan I helped author is long on reforms to provide access to health care coverage, but short on details for reducing the cost of health care itself.
Why? First, because controlling health care costs is tough. Second, because health care access is where the political action is.
Controlling health care costs is tough, very tough. As an earlier post in this blog points out, medical cost inflation, driven by an aging population, new technologies and increasing customer expectations, greatly outpaces overall inflation. (For a tool that shows just how much of an impact this can have, check out Tom’s Inflation Calculator ). Several of the health care proposals address the edges of the cost issue. For example, both Governor Arnold Schwarzenegger’s and CAHU’s Healthy Solutions plans advocate wellness and healthy living programs among other ideas. But most of the plans being debated in Sacramento, fail to attack health care costs head on. Even the one that arguably does, Senator Sheila Keuhl’s single payer plan, SB 840, proposes cost control tools which will be costly and complicated to implement and may not work at all, especially on a single-state basis.
With legislative leaders and the Governor focusing on health care access, so do stakeholders like CAHU. All parties know Weintraub is right: controlling health care costs are the key But no one wants to be out doing the hard work of addressing that issue when the governmental process may pass a law that raises your taxes, harms your clients, or destroys your profession.
As a result, the key issue gets neglected. Fortunately, not by everyone. As Weintraub notes in his article, several folks are trying to tackle this issue. Let’s hope they succeed — and they get the attention they deserve.