Friday, July 31, 2009
Summertime is for fun, but…
As I look back on the summer as it nears the midpoint, I tend to focus on the positive things that have been going on during the months of June and July – Saturday mornings at Carlisle’s Farmers Market, the Concord Band concerts on Wednesday evenings at Fruitlands in Harvard (weather cooperating), a trip out to western Massachusetts to hear the Boston Symphony Orchestra at Tanglewood, an 80th birthday celebration on the Cape, and closer to home, the Lowell Folk Festival which took place on Saturday and Sunday of last weekend.
A highlight of my summer was a trip to Colorado, to the Rocky Mountain Biological Lab in Gothic where my brother-in-law, John Harte, was being honored by his students with a 70th birthday celebration. During the week there were hikes into the mountains, a Wildflower Festival in Crested Butte, and a Saturday of lectures featuring scientists who spend their summers doing research at the Lab. One of the speakers, Paul Ehrlich, professor of population biology at Stanford University, addressed the issue of global warming. As he put it, the issue isn’t whether there is global warming caused by humankind. Instead, the problem is how to get people, especially our senators, motivated to take action. He asked the audience of students and scientists to raise their hand if there were still members in their families who did not believe in global warming. It was shocking to see how many people in that educated audience raised their hands. His message to all of us was “You are the ones who must do something about it.”
Now that I am home and have the time to listen to the news and read the newspapers, I am troubled by the response of our federal legislators to President Obama’s plan for health care reform. How can we finance coverage for the uninsured? Should we end the practice of reimbursing for every medical procedure and doctor’s visit? Should medical providers be grouped together into a network of doctors, clinics and hospitals capable of providing for all a patient’s needs?
As I try to understand these problems confronting healthcare reform, I have turned to several articles in recent newspapers and magazine. Paul Krugman’s column, “An Incoherent Truth,” in Monday’s New York Times was excellent, as was the article “The Cost Conundrum” by Atul Gawande, professor at the Harvard Medical School, in the June 1 New Yorker.
I plan to continue to take part in the joys of summer, but as Paul Morrison suggests in his Forum article, “Why Care about Healthcare?” I’ll drink some strong coffee, read up on healthcare and call or e-mail my congressman and senators.
Why Care About Healthcare?
Why write a Forum article on topics hugely larger than Carlisle, specifically the U.S. healthcare system and the current efforts to change it? I believe the Forum should generally be about Carlisle-only issues. However, before I say why I believe that the healthcare debate should be engaging Carlisleans deeply, I want to make a very few points about the current healthcare system.
First, it is both ineffective (does not provide very good care) and inefficient (is more costly to run than it should be). These are not theoretical or subjective opinions; America has the highest healthcare costs per capita of any industrialized, wealthy nation, and nearly every measure of how well the system performs ranks us dismally low. We spend so much more than other countries that our system is sapping our national competitiveness. If we spent the percentage of our Gross National Product that Canada does, we would spend $800 billion per year less than we do. That would buy a lot of roads, R&D, business investment, energy systems, and scholarships – close to a TARP-size bail-out every single year. Nations do compete and the US is running with weights. When many competitor European countries spend less to get better healthcare than the U.S., no one can sensibly claim that we have a good system.
Second, the percentage of our population with healthcare coverage is lower than in any other wealthy country: 85%. That translates into more than 45 million Americans without healthcare.
As a result, efforts to change healthcare tend to have two main focuses: get a higher percentage covered, and spend less per person. It is far easier to extend coverage than to make the complex, systemic changes needed to lower costs per person. Congress is now gutting significant proposals to reduce costs, but Congress is still finding ways to expand coverage. Expanding an expensive system to cover more people increases costs sharply. This happened in Massachusetts, it will likely happen nation-wide.
Why care in Carlisle? First, the hideous expense will partly be paid for with higher taxes. Wealthier people like us pay more of them. Second, most of us are no longer young. We’re looking forward to receiving more healthcare as we age. If the current train wreck gets much worse, even we may not be safe. Third, this issue will not be settled anytime soon. As expenses balloon (more coverage at too high a cost, remember?) it’s going to come roaring back for as long as it takes our political system to actually fix it – whichever party controls Congress or the White House. Fourth, Carlisleans tend to care passionately about their children. Ballooning healthcare costs and the future near-impossibility of paying at per capita rates that rise more than twice as fast as inflation mean our children are facing a fiscal disaster throughout their earning years. Fifth, the outcome is still in play. You can still pressure our politicians to do something courageous and effective. So, drink strong coffee, read some voluminous media reports, and call or e-mail those who represent us. Be heard.
© 2009 The