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Breaking the healthcare camel’s back

Posted Feb 11 2009 3:28pm

By Mike Stephens

Recently, ABC News ran an op-ed piece, “The Great Health Care Bailout,” in which Nortin M. Hadler, M.D. noted that “‘bailout’ conjures up an act of desperation to keep a sinking boat afloat. In ‘reforming’ our sinking healthcare system we need assurances up front that we are not paying for a similar bailout in disguise.”

After a week of debate, the Senate passed a compromise version of the economic stimulus package that infuses funds into the healthcare system, including for health information technology and Medicaid, among other provisions. The HIT funding is to increase technology adoption by healthcare providers, a strategy that both provides a stimulus for economic recovery and also begins the transformation necessary to expand healthcare coverage while controlling the additional expenditures which will inevitably follow as a result.

Unfortunately, the reliance on information technology to accomplish these goals marks a continuation of the political and health policy preference to avoid the difficult and controversial initiatives that must be adopted in order to make certain this “nibbling around the edges” is not mistaken for authentic, meaningful and sustainable reform.

Let me be clear: Providing readily available patient medical information to healthcare providers will markedly improve the quality and safety of the services given to patients.

It will also reduce the frequent ordering of duplicative diagnostic services and help improve the ability to manage chronic conditions. However, to believe that this is the most important step to controlling increasing healthcare costs that are compounded by expanded healthcare insurance coverage is the first step to an inevitable healthcare financial crisis for which a bailout will be the only remedy.

Consider this: Congress has already passed the TARP (Troubled Assets Relief Program ) in the amount of $700 billion. Add to this the estimated $830 billion projected for the economic stimulus package, and you have more than $1.5 trillion in deficit expenditures added to the nearly $500 billion deficit inherited from fiscal 2007.

But wait, there’s more…Now we must also include the estimated $65 billion in additional federal expenditures to implement the Obama plan for extending health insurance coverage to the uninsured.

With deficits of this magnitude a reality, a financial crisis will follow that will only exacerbate the frail financial state of our country. The latest forecast by the

Congressional Budget Office (released January 8, 2009) projects that from fiscal years

2009 to 2019, the rate of growth in of healthcare spending is the single greatest threat to balancing the U.S. budget in the long term. The effect of excess cost growth during this period is three times the effect of an aging population on healthcare expenditures.

Professor Uwe Reinhardt has clearly outlined the challenges facing our country as we come to grips with the rate of increase in our nation’s healthcare costs. When comparing the U.S. gross domestic product (GDP) per capita healthcare spending with that of other industrialized countries, only 60 percent can be attributed to the higher GDP of the United States. The remaining 40 percent is a result of our paying higher prices and using higher cost technology procedures.

What will be the straw that finally breaks the healthcare camel’s back?

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