George Will’s column with this title in today’s Washington Post sketches a valedictory warning from the man who has served as Director of HHS for the last four years. Leavitt could easily write the health care equivalent of An Inconvenient Truth for health care. But I’m not sure how much good he would do. For whatever reason, the American public seems to have been as anesthetized to the seriousness of the problems as they were numbed to the images of returning body bags at the end of the Vietnam war. None of Leavitt’s admonitions is new, but that doesn’t make them any less frightening.
- At current course and speed, the percentage of average household income spent on health care will nearly double over the next two decades, from 23 to 41%;
- The nation’s current economic difficulties will likely accelerate the expiration of the Medicare Part A Trust from 2019 to 2016;
- 23% of patients have five or more chronic conditions and consume 67% percent of Medicare expenses; a very high proportion of those are smokers;
- And perhaps most tellingly, 30% of Medicare benefits are consumed in the last year of a typical patient’s life.
As someone who has typically let my eyes glaze over when the topic of health care reform is raised, I like to think of the 2008 as the year when I woke up and got at least remedial training in the fundamentals of the problem we face going forward. The punch line, by the way, is that American society will be forced to make health care rationing choices that are as much about fundamental morality as they are about dollars and cents. It is both good and bad news, I suppose, that other countries beat us to this conclusion decades ago.
If you’re looking for remedial reading on health care reform, I’d recommend this very manageable three-pack: Incoming HHS Director Tom Daschle’s Critical; incoming OMB Director Peter Orszag’s June Congressional Testimony;and Brownlee’s ‘s Overtreated.