Reform of health care system can’t wait

By BARBARA SHELLY

How’s the U.S. health care system working out for you?

For me, just so-so. I have a policy, but to keep it I have to stay employed and healthy. In America, nothing is as hazardous to your health insurance as getting seriously ill.

A dear friend of my sister recently died of cancer. The heartbreak was compounded when her family filed for bankruptcy and lost their home. She had carried the family’s insurance policy ... until she became too sick to work.

A while ago my family responded to a fundraising plea for a college student with a rare form of cancer. When he dropped out of school to concentrate on saving his life, he became uninsured and uninsurable.

We all know people in this sinking boat. Yet a recent poll by Rasmussen Reports said that 49 percent of voters think President Barack Obama’s administration should wait until the economy improves before moving forward on health care reform.

“We’re just not going to be able to go there,” U.S. Rep. Emanuel Cleaver, a Democrat from Kansas City, told The Kansas City Star.

We have to go there.

How can we not, when 46 million Americans are without health insurance? When medical bills are a leading cause of personal bankruptcy? When health costs are crippling businesses?

The cost of employer-paid health insurance in Missouri soared by more than 76 percent in eight years, according to consumer group Families USA. In that period, 2000 to 2007, family health insurance premiums for Kansas workers increased five times as fast as median earnings.

The debate over what to do about this is more polarizing than it needs to be. Mention “health care reform” and politicians takes sides faster than kids organizing a game of kickball.

One side views efforts to expand access to medical insurance as a socialist plot. The other side sees the shadowy presence of the pharmaceutical and medical equipment industries behind every curtain.

But if you step back from the fray, you find remarkable consensus among experts about health care’s core problem, and the way to begin fixing it.

Medical care accounts for 17 percent of the U.S. gross domestic product—more per capita than any nation in the world. But much of that care is wasted. Some researchers believe a third or even a half of the $2.4 trillion spent on health care in our country does nothing to improve health.

Here’s the reason: Most of our health care systems, including Medicare and Medicaid, pay for services instead of results.

“The fee for service mechanism prompts unnecessary services,” said Sandy Praeger, the Kansas insurance commissioner.

Healthy habits

Shifting compensation from services to results would mean encouraging healthy habits, reforming technology and getting centralized medical records, doing a much better job of coordinating care, and developing “best practices” to treat symptoms and diseases.

It would require a big shift in the way we approach chronic illnesses, such as heart disease and diabetes, that are hugely expensive but often preventable. Paying to help someone stop smoking is a lot cheaper than paying for a heart bypass operation.

No one thinks health reform will be easy. We’ll have to spend money so that people have access to care while saving money by stopping waste and fraud. Tough decisions will have to be made about cutting off expensive, unproven therapies. Government, I believe, is going to have to play a bigger role.

But we have to go there. We, as a nation, are better than our health care system. We are too smart to keep paying more and getting less. We are too decent to allow people to be ruined because they had the misfortune of getting sick.

X Barbara Shelly is a member of the Kansas City Star editorial board. Distributed by McClatchy-Tribune.