Health-care reform and costs: The true story

It seems that much of the media coverage emphasizes the cost of comprehensive health-care reform. What about the cost of not enacting health care reform?

Let’s talk about the deficit. A March 11 letter from the Congressional Budget Office (CBO) estimated that the current version of the Senate health care reform bill would yield a net reduction in federal deficits of $118 billion from 2010–2019.

This is, after all, the much-reported cost of the reform. Remember, this doesn’t take into consideration the expected cost reductions from the many cost-containment and increased-regulation strategies in the Senate bill.

In contrast, the Urban Institute and the Centers for Medicare and Medicare Services determined that without comprehensive health care reform:

• U.S. spending on health care will climb from $2.39 trillion in 2008 to $4.28 trillion in 2017. A large share of that will be absorbed by state and federal programs and will balloon the federal deficit.

• There are currently about 48 million people uninsured in this country. Under the best-case scenario, the number of uninsured will increase to 53.1 million in 2014 and to 57 million in 2019. The worst case scenario puts those numbers at 57.7 million in 2014 and 65.7 million in 2019.

• Employer spending on health premiums will increase from $430 billion on 2009 and to between $740 billion and $885 billion in 2019. Individual and family spending will increase from $326 billion in 2009 and to between $478 billion and 548 billion in 2019.

• The cost of uncompensated care – which all of us pay in higher taxes and insurance premiums – will increase by 72 percent under the best-case scenario and 128 percent under the worst-case scenario by 2019.

• A June 2009 study by the Council of Economic Advisors concluded that health care’s share of GDP will continue to rise rapidly. The share is 17 percent now. It will be 20 percent in 2019, 28 percent in 2030 and 34 percent in 2040 if we don’t do something to control health-care spending. Historical data backs these projections. In 1990, the United States spent 12.3 percent of its GDP on health care. By 2007 that had grown to 16.2 percent.

Let’s look at the impact of U.S. health-care costs on our ability to compete for jobs in the global economy.

In 2006, the U.S. spent $6,567 per person for health care. The most any other industrialized country spent was Switzerland at $4,311. Most others spent less than $3,500 per person with Japan only spending $2,529 per person.

That means the United States starts out with a $2,000-$4,000 handicap per worker when competing for jobs.

We’ll be sorry and broke if we don’t pass reform

The health-care reform bills currently pending in Congress are by far the most serious effort in years to rein in the staggering growth of health-care spending. They include virtually all the best ideas from experts about how to control these costs while also improving the quality and coordination of care for all of us.

If we throw this opportunity away, we are going to be sorry and broke for a long, long time.

When evaluating policy, it is as important to look at the cost of not taking action as well as the cost of taking the action. To bring it down to a personal level, if you just looked at the cost of sending your children to college, you would probably not make the decision send them, especially if you had limited resources. But, if you looked at the lifetime earning potential of college graduates, the decision to make that investment becomes much easier.

The media gives far too much attention to the cost of health-care reform and far too little to the cost of not implementing reform, inadvertently leaving the public ill-equipped to make informed decisions about a major policy initiative.

Webber is the executive director of Health Action New Mexico, a statewide health consumer advocacy organizing that has been working for affordable, accessible health care for all New Mexicans since 1995.

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