Crisis of cost; crisis of care

Saturday's editorial that the health-care debate is moving away from what must be its central goal - cost control - and finds fault with members of both parties for it.

The crisis in our country's health care system is twofold. That 46 million Americans are uninsured is an embarrassment to our greatness as a nation, but skyrocketing health care costs are a severe threat to maintaining any semblance of that greatness.

The average family of four will spend $16,771 on health care this year (combining employer contributions, employee contributions and out-of-pocket costs) - a figure that has risen a startling 37 percent from $12,214 in 2005, according to the Milliman Medical Index. Amid the recession, employers shift ever more of those costs to their workers, but few families see their wages increase at anywhere near the same rate.

That staggering cost growth likewise burdens government, which pays for the health care of millions through Medicare and Medicaid. The Congressional Budget Office says that, "In the absence of significant changes in policy, rising costs for health care will cause federal spending to grow much faster than the economy, putting the federal budget on an unsustainable path."

As President Obama said in his press conference, "If somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit ... that's what we have right now."

Those projections are terrifying. Unfortunately, the health care reform debate is quickly falling off the tracks, pushed awry by predictably partisan forces. Democrats are so hung on the laudable goal of providing health care to all - a move that, in and of itself, will reduce the costs of "uncompensated care" for others - and Republicans are so intent on stopping the conversation altogether - that few are genuinely working to reduce costs in the long run. It's hard to say whose blindness is more dangerous - the Democratic myopia in the driver's seat, or the Republicans with their heads under the seat, fumbling to yank the keys out of the ignition.

Consider:

- Many economists say costs can be driven down by taxing employer contributions to health insurance and redirecting credits to employees, essentially releasing workers into a broader health care marketplace for insurance rather than shackling them to their employers' plan, while increasing competition among insurers at the same time. President Obama essentially endorsed the concept in his news conference Wednesday, and a bipartisan group of 14 U.S. senators has authored a bill based on it.

- A widely touted mechanism to reduce costs is to pay doctors on a salary basis rather than the current fee-for-procedure method, removing financial incentive for them to prescribe tests or procedures that may unnecessary.

- Tort reform is another form of cost control that needs serious exploration, to seek out ways to limit the practice of defensive medicine without restricting patients' ability to recoup damages when they have been legitimately wronged.

Yet none of these measures are central to any of the bills under consideration.

Any avowed "fiscal conservative" should be heavily invested in halting the damage the rising medical costs will wreak on the federal budget in years to come if the system is not reformed. Instead, those who cry "deficit" the loudest - including South Carolina's Republican Sen. Jim DeMint - are unhealthily focused on trying to "break" President Obama and prevent anything that could be construed as a Democratic legislative victory.

As our congressmen head back home from Washington for their August recess, we hope Americans will demand they take the cost crisis as seriously as the coverage crisis, and demand that grandstanding obstructionists like DeMint either get to work or shut up.

The average family of four will spend $16,771 on health care this year (combining employer contributions, employee contributions and out-of-pocket costs) - a figure that has risen a startling 37 percent from $12,214 in 2005, according to the Milliman Medical Index. Amid the recession, employers shift ever more of those costs to their workers, but few families see their wages increase at anywhere near the same rate.

That staggering cost growth likewise burdens government, which pays for the health care of millions through Medicare and Medicaid. The Congressional Budget Office says that, "In the absence of significant changes in policy, rising costs for health care will cause federal spending to grow much faster than the economy, putting the federal budget on an unsustainable path."

As President Obama said in his press conference, "If somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit ... that's what we have right now."

Those projections are terrifying. Unfortunately, the health care reform debate is quickly falling off the tracks, pushed awry by predictably partisan forces. Democrats are so hung on the laudable goal of providing health care to all - a move that, in and of itself, will reduce the costs of "uncompensated care" for others - and Republicans are so intent on stopping the conversation altogether - that few are genuinely working to reduce costs in the long run. It's hard to say whose blindness is more dangerous - the Democratic myopia in the driver's seat, or the Republicans with their heads under the seat, fumbling to yank the keys out of the ignition.

Consider:

- Many economists say costs can be driven down by taxing employer contributions to health insurance and redirecting credits to employees, essentially releasing workers into a broader health care marketplace for insurance rather than shackling them to their employers' plan, while increasing competition among insurers at the same time. President Obama essentially endorsed the concept in his news conference Wednesday, and a bipartisan group of 14 U.S. senators has authored a bill based on it.

- A widely touted mechanism to reduce costs is to pay doctors on a salary basis rather than the current fee-for-procedure method, removing financial incentive for them to prescribe tests or procedures that may unnecessary.

- Tort reform is another form of cost control that needs serious exploration, to seek out ways to limit the practice of defensive medicine without restricting patients' ability to recoup damages when they have been legitimately wronged.

Yet none of these measures are central to any of the bills under consideration.

Any avowed "fiscal conservative" should be heavily invested in halting the damage the rising medical costs will wreak on the federal budget in years to come if the system is not reformed. Instead, those who cry "deficit" the loudest - including South Carolina's Republican Sen. Jim DeMint - are unhealthily focused on trying to "break" President Obama and prevent anything that could be construed as a Democratic legislative victory.

As our congressmen head back home from Washington for their August recess, we hope Americans will demand they take the cost crisis as seriously as the coverage crisis, and demand that grandstanding obstructionists like DeMint either get to work or shut up.