Controlling health care costs is crucial to achieve reforms

April 8, 2009
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And so it begins. In the first week of March, barely more than one month as President of the United States, Barack Obama conducted a summit meeting to discuss health care reforms and rekindled the national debate. Then came Obama's announcement that he wanted to lift the eight-year ban on federal funding for embryonic stem cell research. Barely more than one week after the Washington summit, Gov. Jennifer Granholm was set to meet U.S. Sen. Debbie Stabenow and Wisconsin Gov. Jim Doyle for a Midwest Regional White House Forum on Health Care Reform — in Dearborn. In the land of the UAW and the near bankrupt, onetime world leaders of automotive manufacturing. In the land in which unions set the American standard for health care benefits and added more than $1,700 to the price of every American-made car. In the land where the average cost of a hospital admission is $10,495, compared to $7,208 in Holland/Grand Haven or $9,838 in Grand Rapids. The land where there are daily lessons of what not to do. Ground zero.

But we don't believe that's why Granholm and her Democratic friends elected to meet in Dearborn.

As this issue goes to press on the eve of the Dearborn rally for reform, Health Quarterly reports that the recession and continuing job layoffs are having significant impact on hospital charity care and unpaid billings, which is soaring across Michigan.

While hospitals only begin to absorb "charity care," business owners know that is a pass-along cost which will further inflate health benefit costs at a time when they simply can't foot the bill.

David Czurak reports on the Kaiser Family Foundation national survey showing — not surprisingly — that half of the nation's households last year skipped or postponed medical treatments. All the prevention education in the world is not likely to change that behavior in this recession, which will elevate the number of people coming into health care systems with more grave illnesses, and less, if any, money for treatment.

While Washington and Michigan gather the stars of health care grievances, one can certainly project that "reform" will be related to entitlement of the masses. Michigan State University Center for Ethics and Humanities in the Life Sciences medical ethicist and professor Leonard Fleck weighed in last month suggesting rationing health care, as his book "Just Caring" was published by Oxford University Press. He suggested in a piece published by Medical News Today: "We want everything contemporary medical technology can offer that will improve the length or quality of our lives as we age. But as presently healthy taxpayers, we want costs controlled." In discussing expensive procedures with marginal benefits or benefits to smaller numbers of people, he suggested, "If we are unable to control health care costs, we have no chance at health care reform."

It does not take a politician to resolve this issue. Former President Ronald Reagan and his then-OMB director David Stockman established Heath Systems Agencies to plan and moderate (moderate, not eliminate) the "arms race" for better, more high-tech, more high-priced policies and procedures. The Alliance for Health, which has a 60-year history as a health planning agency became one of the HSAs and continues to assist in that battle to watchdog the procedures, technology and policies that continue to escalate cost. Its experience and history of study are likely good sources for this beginning, should real reform be considered.

—Carole Valade

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