Health Care Sacrifice?

Jul 26, 2009 1:02pm

"Mr. Obama does the public a disservice by acting as if (his health care reform efforts) will not require anything from them in return," the Washington Post editorial board writes this morning.

The editorial board didn't like the president's answer to my question Wednesday night.

I'd noted that many health care reform experts say that – while not negating the overall positive changes to the health care system the president wants to make – there is going to have to be some sacrifice in order for there to be true cost-cutting measures, such as Americans giving up tests, referrals, choice, end-of-life care.  Are the American people going to have to give anything up in order for this to happen, I asked.

President Obama's response: "They're going to have to give up paying for things that don't make them healthier.  And I — speaking as an American, I think that's the kind of change you want.

"Look, if, right now, hospitals and doctors aren't coordinating enough to have you just take one test when you come because of an illness, but instead have you take one test, then you go to another specialist, you take a second test, then you go to another specialist, you take a third test, and nobody is bothering to send the first test that you took, same test, to the next doctors, you're wasting money. You may not see it, because if you have health insurance right now, it's just being sent to the insurance company.  But that's raising your premiums.  It's raising everybody's premiums.  And that money, one way or another, is coming out of your pocket.

"Although we are also subsidizing some of that because there are tax breaks for health care. So, not only is it costing you money in terms of higher premiums, it's also costing you as a taxpayer. Now, I want to change that. Every American should want to change that. Why would we want to pay for things that don't work? That aren't making us healthier?"

So, judged the Post, "Mr. Obama's basic answer was no….This all-gain-no-pain stance may be politically advisable; people are increasingly edgy about how reform will affect their own health care…..

"But Mr. Obama's soothing bedside manner masks the reality that getting health costs under control will require making difficult choices about what procedures and medications to cover," the Post continues. "It will require saying no, or having the patient pay more, at times when the extra expense is not justified by the marginal improvement in care. Mr. Obama is right that sticking with the status quo is a bad alternative, but he isn't leveling about the consequences of change."

- jpt

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