Is The Reform Debate Too Narrowly Focused?

Over the past sixty years, many solutions have been offered to reform our nation's broken health care system - a system characterized today by relentlessly rising costs, and a growing inability of people to pay for it.

Time and again, national reform proposals have been introduced and scrutinized primarily for their fiscal impact. Each time, these proposals have failed to achieve the support necessary to be implemented.

We have long felt that fiscal analysis alone is insufficient to the task of reform. Why? Because whether you are a political leader, a corporate CEO, an economist, a school teacher, a parent -- when you or someone very important to you becomes ill you want attentive, quality care immediately.

It's not just that the increasing cost of health care is reducing opportunities to invest in other areas of our society, or that it is reducing our competitiveness in the global economy, or that it is rife with inefficiencies. It is all that. But from the perspective of a society that values attention to the suffering of its members, it is also something more.

There are a lot more folks out there talking about broadening the perspective on the health care reform debate beyond finances, including Susan Blumenthal and Denis Cortese, who espouse seven strategies to address the nation's health care crisis. Lincoln Weed and Lawrence Weed argue for addressing medicine's missing foundation. And Anne Tumlinson reminds us not to overlook our long-term care facilities when embarking upon reform.

Why Healthcare Costs So Much

Ezra Klein takes on the onerous task of detailing why U.S. healthcare costs so much. He opines:

The hypothesis I'm going to offer is not definitive, and is not meant to be. But my read of the evidence is that at the root of our health care problem is an almost pathological aversion to making hard choices -- an aversion that has, in its steadiness and implications, become the most consequential choice of all.

At the risk of cannibalizing an upcoming print feature, health care costs are on autopilot. In other areas of life, decisions are made based on whether a particular use of money is a good value as opposed to other uses of that money. Given a budget of $10, a hungry journalist who wants to expense his lunch must choose between the sandwich and the soup. He cannot choose both.

The American health care system doesn’t work like that. There is no budget. We don't want one. We’re profoundly uncomfortable saying that a person’s life, or health, is not worth the price of a particular procedure. And so we don't. We are too terrified of waiting for a procedure to even think of not providing it. We ask only that the procedure be proven effective against a placebo. Beyond that, we make no decisions, and we prefer it that way. Better to let five people die passively than kill one consciously.

Andrew Sullivan is also exploring this issue on his blog. As always, the posts are telling.

The Greater Worry - Health Costs or Job Loss?

President Obama's health care reform road show comes to California today. Catholic Healthcare West's president/chief executive officer Lloyd H. Dean will be speaking at the town hall about health care costs and what we can do to bring them under control. You can watch the live feed at 10:30 am (PST) this morning.

Meanwhile, we've released the findings from our national Health Security Index survey. Most surprising is that in the current environment of corporate layoffs and downsizing, more people in the U.S. are worried about health care costs than are worried about losing their jobs. And fully 83% want Congress to act this year to bring meaningful reform to our health care system. It's clear the country is ready for change - the question now is whether all the conflicting interests can come together and agree on a plan that will work.