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Saturday, June 20, 2009

Cost Versus Coverage in Health Care Reform

Health care reform has come down to a contest between two issues, cost and coverage.

Cost is an issue because nearly 17% of our economy is now devoted to health care and that number continues to rise because expenditures for health care are rising faster than the growth of the economy as a whole. Students of the issue foresee the day when the government will no longer be able to pay its health care bill from its own funds or borrow the money to do so.

Coverage is an issue because some 47 million Americans are without health insurance. In the modern era, the lack of health insurance can force a patient to choose between foregoing needed health care and facing financial disaster.

Measures that address the coverage issue provide a benefit for people in need and are therefore politically attractive.

Measures that address the cost issue place restraints on established practices and are therefore politically hazardous.

The contest arises because measures directed at the coverage issue involve new expenditures of prodigious amounts of money, thus exacerbating the cost issue.

Added to that is growing concern over ballooning budget deficits at the federal level.

I have said over the years that the cost of health care continues to rise because the pain of paying is less than the pain of doing something about it.

That may be changing.

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