The Capitol-Journal - Bill Roy: Dole center takes on biggest issue of the day
Published By: Bill Roy - The Topeka Capitol-Journal
August 2, 2008
The Robert J. Dole Institute of
Politics will present a program entitled
"Reforming the U.S. Health Care System:
Supporting the Role of Individuals." The
invitation-only event runs from 12:30 to 5 p.m.
Monday, and former Sen. Dole will preside over
a series of panels consisting of mostly
Midwestern academics, foundation gurus and
health administrators.
This event is
sponsored by the Bipartisan Policy Center,
founded last year and headlining four former
U.S. Senate majority leaders, Republicans Dole
and Howard Baker and Democrats George Mitchell
and Tom Daschle. Their salutary goal is to find
bipartisan acceptable solutions for problems
like energy, environment and health care and
then pass them on to their old colleagues for
implementation.
Just as windy Topeka was
the site of oilman T. Boone Pickens' first
public meeting pitching his solutions for
America held-hostage by foreign oil,
health-conscious Lawrence will be the site of
the Bipartisan Policy Center's first forum on
health care.
The role of individual
responsibility in protecting one's own health
is not controversial. How to get people to lose
weight, exercise, have periodic medical
checkups and follow healthy lifestyles is
controversial. It involves questions like how
much public money to spend and the roles
reimbursed health care providers should play in
educating and supporting
individuals.
Every day we see people who
are morbidly overweight, and often smoking. We
wince at their suffering, projected short life
spans and the load they are placing on the
health care system. Change such destructive
behavior, and America's health statistics,
which aren't very good, will become much
better.
To the extent "supporting the
role of individuals" means helping them
establish healthy lifestyles, the conference
can and should have plenty to say.
To
the extent "supporting the role of individuals"
means helping people prudently shop health
insurance and the health care system, agreement
is far less likely. Making prudent purchases in
our complicated health care milieu is difficult
at best and impossible at worst.
To be a
bit picky, the program is in part misleading
because our country doesn't have a single
health care system to reform. We have many
health care systems, the sum of which leaves
out 47 million Americans, nearly one in
six.
It is a combination of private and
public financing and private and public
services. Nearly 60 percent of the cost of
American medical care is paid for by
government, an amount similar in both
proportion and total costs to national systems
that guarantee financial access to services for
all residents.
The federal government
pays for a surprisingly well-liked Veterans
Health Care System that covers 8 million
deserving veterans at costs approaching $40
billion annually. It is 100 percent socialized
medicine — the facilities are owned by the
government, and its employees are government
employees.
Two other government-financed
programs cover many of the nation's neediest
citizens, though services are privately
provided.
Medicare, the program for the
elderly and disabled, covers 44 million people
at a cost of $374 billion, 13 percent of the
federal budget in 2006.
Medicaid is a
federal-state financed and state-administered
program for the poor and selected children. It
has 60 million beneficiaries and costs $300
billion. The government also provides health
care for members of the armed services and
their dependents.
The biggest piece of
the bizarre system is employment-based health
insurance that covers 160 million working
people, their families and some retirees. About
10 million individuals and families buy private
health insurance or pay out of
pocket.
The multiple systems cost $2.2
trillion, one-sixth of the gross national
project, and $7,000 per person. Costs increase
at about twice the growth in the GNP each
year.
So nothing is simple. How you gain
financial access to health care is decided by
employment, age, health status, financial
status, military service, prudence and luck —
all of which change from time to
time.
Bill Roy is a retired
physician and former member of Congress. He has
a law degree and lives in Topeka. He may be
reached at wirroy@aol.com
