Wednesday, February 25, 2009

The President's Address, 2/24/09...

I was particularly interested in listening for Mr. Obama's address to congress. The transcript and video of his address are available on the White House blog, at So, what did he really have to say about healthcare reform?

"I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year."

I'm particularly interested in the approach... he mentions the healthcare meltdown as weighing down "the conscience of our nation" - that's a hint that he and I would agree that we have a moral failing in the system of healthcare rationing we have in America. (Oh, you don't think we have rationing? Just ask our uninsured if they have access to the most basic of preventive services - they don't do pap smears in the Emergency Department, Mr. Bush. Or, ask our nation's retired military if they can find a local specialist, or even primary care doctor, to take care of them. I've talked about this 'economic rationing' before...)

But, the language that is stressed most is that America demands healthcare reform as an economic issue. Finally! Someone is saying it out loud! If you can't agree on the morality issue, then I think we can all find that we should work to reduce the high cost of healthcare, as it is a significant contributor to our economic burden.

I've often told of the per capita cost of health care as it relates to my own age... In the year I was born, 1962, the per capita cost for the US in the provision of health care was ~$200. And, the money we spent on health care was something like 5% of our GDP. The latest numbers show that per capita healthcare costs are now ~$8000+, and has risen to represent 16.3% of GDP in 2007. And, the trend of an aging population and costs rising faster than inflation would anticipate that healthcare costs will rise to 20% of GDP in 2017.

How does that compare with other countries? The data reported in this article is now several years old, and lists US per capita costs as $4000 in 2001. But, the article does have a nice comparison of costs across countries.

And, the journal Health Affairs has a nice editorial piece which calls for reform now. My favorite comment in the article is the revelation of the two major barriers to reform: "Democrats and Republicans".

So, the president is positioning healthcare reform as an economic issue, and now our task is to be diligent to watch that the reform process still includes the moral issue in the proposals.

"Yes, we can."

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