Thursday, January 21, 2010

Earth to Washington: baby steps won't help

Democrats, I love you, but please shut up. Stop talking right now about “incremental steps." Good grief, the current health bills in Congress, for all their mind-boggling verbosity, are incremental steps. They do not get at the tangled hairy roots of the problems we're facing.

If incremental steps worked, George W. Bush's Medicare prescription drug benefit would have been a godsend. Instead, the original 2003 cost estimates of around $400 billion over a ten-year period escalated by 2005 to $1.2 trillion, and some analysts now say that real costs are closer to $21.9 trillion. Meanwhile, the plan's doughnut hole leaves many Medicare recipients without necessary medications.

Pharmaceutical companies, however, have made out like bandits: after persuading Congress to put no caps on drug prices, they began systematically raising prices on the most popular drugs. According to a 2008 study conducted by AARP, who initially supported the legislation, the average price of the most widely used drugs on the market between 2002 and 2007 increased 50.4%, compared to an overall inflation rate of 19%. In 2008 and 2009 brand-name drug prices increased by another nearly 20%. This week "the nonpartisan General Accountability Office said it found 'extraordinary price increases' for 321 brand-name drugs, with prices jumping by 100 percent to 499 percent - and in a few cases by more than 1,000 percent" since the year 2000. Apparently many pharmaceutical companies are raising prices yet again in anticipation of some sort of health-care reform.

As long as that reform is incremental, Big Pharma is unlikely to charge U.S. consumers what the rest of the world pays. As long as reform is incremental, insurance companies will continue to stay profitable by denying coverage or making it unaffordable to those who need it most. As long as reform is incremental, unnecessary but expensive procedures will proliferate in the suburbs, while the rural poor will have to travel great distances for medical care and the urban poor will die in crowded emergency rooms.

If we are going to provide basic, affordable health care for all--and even if all we aspire to do is to retain excellent, affordable health care for the affluent--we have to start from scratch. Congress must quit bickering and start studying what works (and what doesn't) work in other developed countries, all of whom have universal health care at much lower cost than ours (click here for further info about the graph). According to T.R. Reid in The Healing of America, Taiwan's government did this in the late 80s and early 90s. Switzerland's did it in the mid 90s. Both countries found ways of completely reinventing their health-care systems, ways that suited each country's particular needs.

We can do it too. Someday we will have to do it. Here's hoping we will decide to do it before ill-managed health care topples us into another Great Depression.

1 comment:

Anonymous said...

LaVonne, you make the mistake of assuming that the Democrats care a whit about health care. The bills in House and Senate were about power, bureaucratic power, about a huge new pool of government union members and so forth.

Remember back in the mid-90s when Senator Breaux and a Republican (whose name I forget) headed a commission to work out a solution to the demographic implosion of Medicare, at that time expected sometime in the late 20 teens? They actually reached a solution that was actuarially sound.

Clinton just ignored it. He did not want the problem solved in a reasonable, efficacious way. He wanted a festering problem.

You give them too much credit. They don't want to fix things. They want to control things.