Can We Afford to "Go Slow"?

All the hullabaloo about Rep. Clyburn's comments and the partisan rancor that has crept into the debates in Washington has revived what I predict will be the favorite health care question for the punditocracy this year:  "Should the president really push ahead, or should we try to tinker around the edges?"  We'll see this same question any time we hit a bump in the road.  But the answer must always be, "Are you kidding me with this incremental stuff?  We're running out of time."

Let's, as always, express bewilderment that living with 47 million Americans who lack access to basic health care is somehow OK for those who want a reason to delay comprehensive health care reform.  But we can't ignore that that number is on the rise, with the conventional presumption being that every 1% increase in the unemployed will lead to 1.1 million additional uninsured.  If we're truly jumping from 6% unemployment to 9% this year (and that's with the stimulus working), then we just don't have time to incrementally fix our lack of access.

Costs are even more disturbing.  The news reports today are full of a report from the Public Interest Group (PIRG) who has projected when private employer-based insurance will look like at the end of the Obama Administration if we don't start fixing our broken system.  The results are eye-popping.  The average family insurance plan currently costs $11,381.  The projection for 2016?  $24,291 - over double.  Put it another way, in 2016 a family of 4 whose income is at the Federal Poverty Line could spent the family's entire income on health care - and still not cover the cost.

Sound too "doomsday" a prediction?  Our premiums nearly doubled during the last administration, too.  In 2000, Health Affairs reported than the average family plan was $6,348.  Today, PIRG tells us that number $11,381 (and theirs is the lowest number I've seen.)  Meanwhile, we've seen deductibles increase, co-pays increase, the percentage that employers spend on premiums decrease, the workers' share of premiums increase and the number of employers who drop coverage entirely increase.  Don't think for a second that doubling the cost of insurance again won't exacerbate all of those trends.  If we can somehow stomach 50 million Americans without access to health care, could we stomach 100 million?

PIRG's report puts an individual face on what the Congressional Budget Office has already predicted is coming.  The U.S. already spends 16% of our Gross Domestic Product on health care while countries with universal health care spend less than 10%. The CBO has publicly predicted the costs will rise to 20% of our GDP by 2017 if left unchecked.  That's $4.3 trillion dollars.  And, it should be obvious from today's headlines, it's $4.3 trillion dollars neither the government nor we, its citizens can afford.

It turns out your grandmother was right - when it comes to health care, time is money.  If we don't even start fixing out dysfunctional system, we'll soon be out of both.