I wasn’t able to watch President Obama’s speech last evening.
I did read it at Politico.com, though, and I have hope in him that he can pull our country through this giant morass that we are in.
The part of his speech relating to health care is below.
For that same reason, we must also address the crushing cost of health care.
This is a cost that now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last eight years, premiums have grown four times faster than wages. And in each of these years, one million more Americans have lost their health insurance. It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it’s one of the largest and fastest-growing parts of our budget.
Given these facts, we can no longer afford to put health care reform on hold.
Already, we have done more to advance the cause of health care reform in the last thirty days than we have in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for eleven million American children whose parents work full-time. Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time. And it makes the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control.
This budget builds on these reforms. It includes an historic commitment to comprehensive health care reform – a down-payment on the principle that we must have quality, affordable health care for every American. It’s a commitment that’s paid for in part by efficiencies in our system that are long overdue. And it’s a step we must take if we hope to bring down our deficit in the years to come.
Now, there will be many different opinions and ideas about how to achieve reform, and that is why I’m bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.
I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.
The gist of President Obama’s plan is to provide comprehensive health care for everyone (i.e. “open access” to health care) while reigning in costs. We’re going to spend more money to implement electronic medical records, to find a cure for cancer, and to invest in preventative care.
These are all laudable goals, but a system with increased expenses and decreased costs is difficult or impossible to attain without significantly affecting access to care and quality of care.
Want to take a bite out of cancer deaths? The cancer caused by smoking cigarettes kills a quarter of a million people each year. Put a $10 “advance health care tax” on every pack of cigarettes sold to pay for future health care costs. That will cut down dramatically on smoking and will increase funding for future smoking-related cancer cases.
Electronic medical records will help in the administration of health care, but only if the records are universal, complete, and easily accessible. No health care provider is going to spend tens of thousands of dollars to implement an electronic medical records system when there is no unified records system and when the return on the investment amounts to decreased productivity and increased costs. Kevin MD has posted a lot of information on this problem. Read more about his posts here.
The thing about President Obama’s speech that worries me the most goes back to the Engineer’s Triangle.
There is a dynamic tension between quality medical care, timely medical care, and free medical care.
If the government is going to make medical care free or low cost, that leaves two other variables in the equation.
Are we going to settle for free and timely care and take a hit in quality?
Or are we going to get free and quality care that will be difficult to access?
I’m betting on the second option – one in which care in this country will become time-rationed like in every other socialized medical system. It won’t be that you can’t have the medical care, it’s just that you may die waiting to receive it because so many other people are also in line to get the same free care. After all, we only have “limited resources” and we have to contain costs, you know.
Much of the medical care that some take for granted now, such as expensive lifesaving drugs and expensive end-of-life care, will become unavailable.
Not sure how I feel about this one. I think that our nation wastes exorbitant amounts of money on expensive care that has little or no effect on patient outcomes. That money could be put to much better use by providing primary care services to patients who cannot afford and currently have no access to it.
I’m just concerned that the pendulum is going to swing too far in the other direction and that increasing amounts of expensive but reasonable treatment will also be curtailed to cut costs.