Wednesday, November 02, 2005

Rearranging the Deck Chairs on the Titanic

is an aphorism people use to describe an activity that seems rather pointless in light of other, more important things that are going on.

I was reminded of that aphorism by several recent stories in the newspapers. The first was about an agreement between General Motors and the United Auto Workers under which company-paid health care benefits will be reduced for both GM employees and retirees.

Then a few days later there were reports of retail giant Wal Mart trying to rein in health insurance costs by, among other things, hiring more part-time people, hiring healthier people, charging more for dependent coverage, etc.

Last week while I was in Iowa the Omaha World Herald carried an editorial about ideas being explored by the Nebraska government to reduce the financial burden of Medicaid. One proposal was to give Medicaid beneficiaries vouchers of fixed dollar value that they could use to buy health care.

In these and other similar cases, employers and governments are responding to the high and escalating cost of health care by passing the financial burden on to somebody else – in most cases to patients.

I think it remarkable that in all these situations there is almost no discussion of the larger problem, which is that the cost of providing health care is too high and rising too fast.

The obvious remedy is to get cost down. But the prevailing assumption seems to be that providing health care costs what it costs and there is nothing that can be done about it.

One doesn’t have to think about it very long to realize the falsity of that assumption. There is nothing being done that can’t be done less expensively if imaginative people put their minds to it and want to do it bad enough.

While our health care system is not about to sink like the Titanic, it is clearly heading for some kind of crisis. In the meantime, it seems that we will keep rearranging the deck chairs.

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