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Can health care be fixed?

Byline: The Register-Guard

There is little disagreement that the U.S. health care system is an unfair, inefficient, hyper-expensive mess. Americans are spending more than $2 trillion - that's a 2 followed by 12 zeros - every year on health care, 16 percent of the total Gross Domestic Product.

And yet, despite spending more than any other modern industrial county on health care, about 15 percent of the population of the world's richest nation has no health insurance. They must wait until they experience a health crisis, then drag themselves to the nearest hospital emergency room and wait for hours to receive the most expensive care money can buy. Every time that happens, insurance premiums, hospital rates and prescription drug costs inch up another notch in the United States. It's the dumbest "universal" health care in the world.

More than three-quarters of the American public believe it's a "very serious problem" that 47 million of their fellow citizens lack health insurance. Sixty percent think it's the government's job to guarantee that everyone in the United States has adequate health care.

One-third of U.S. adults believe that the U.S. health care system has to be rebuilt completely. Twenty percent of U.S. adults report "serious problems" paying medical bills. Nearly one-third of Americans spent more than $1,000 out-of-pocket on medical expenses in the past year.

Health insurance premiums have risen 78 percent since 2001, four times the rate of wage increases. At the same time, the number of workers covered by health insurance through their jobs fell again in 2006. The percentage of all employers offering health insurance in the past eight years peaked in 2000 at 69 percent and has fallen steadily since, hitting 59.7 percent this year.

Average out-of-pocket costs for deductibles, co-payments for medications and co-insurance for physician and hospital visits rose 115 percent since 2000. Inability to pay for an unexpected health crisis is the No. 1 reason people file for personal bankruptcy in this country.

Could 2008 be the year health-care reform becomes a decisive election issue? One-third of voters rank health care reform just behind the Iraq war as the most important challenge facing the next president.

But the 85 percent of Americans who have health insurance are so afraid of losing it that they're not willing to experiment with radical alternatives that could threaten their current coverage. They know the system is broken, but there's no consensus on how best to fix it.

That's not lost on the health care industry players who have enormous financial incentives to preserve every dime provided by the status quo. Not to mention the confidence they gained after successfully torpedoing Hillary Clinton's first run at national health care reform in 1993-94.

Even the most ardent Democratic advocates of reform almost never mention that real universal health care will require some level of sacrifice from everyone to control costs. And costs will be the 2-trillion-pound gorilla of the process.

All reform plans contain unproven assumptions about how much can be saved through efficiency, computerized health records, an emphasis on prevention and healthy lifestyles and better chronic disease management.

Pessimists believe real reform won't gain traction until the number of uninsured reaches at least 25 percent of the population. The only way the optimists can prevail is if presidential candidates hear from enough voters that real reform can't wait, and the American people are willing to make sacrifices to provide all of their fellow citizens with health insurance.
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Title Annotation:Editorials; Everyone wants reform, but the barriers are huge
Publication:The Register-Guard (Eugene, OR)
Article Type:Editorial
Date:Nov 19, 2007
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