A couple of recent news stories reminded me of the dirty little secret about healthcare that no one wants to talk about, the proverbial elephant in the room. All those pills, surgeries, x-rays, medical care? It costs money!
Yes, Virginia, quality medical is not a right, not guaranteed in the Constitution, not something good-hearted corporations and companies, whether for-profit or not, are obliged to hand out like candy corn at Halloween. It costs money. Billions of dollars a day.
This appears to be something we all forgot in the warm fuzzy moments of watching military transport planes fly critically ill people out of Haiti to Florida hospitals. Who was going to pay for all this medical care? For the months of hospitalizations and rehabilitation these people were going to require? When the state of Florida, rightly so, asked the same question, prompting the halting of those military convoys, it ended up on the receiving end of a world-wide outpouring of boos and hisses.
Hey guys, back off. How would you feel if we sent thousands of Haitians to your house assuming that you would just feed and house them out of the goodness of your heart?
Healthcare is no different. Someone has to pay. In the Haitian issue, the federal government finally agreed to pick up the check and the military transports resumed.
Which brings me to the other news event that prompted this blog. President Obama released his FY 2011 budget recently. As you may have heard, he’s trying his best to reign in out-of-control budget deficits by freezing most parts of the budget over the next three years that are not related to entitlement programs or defense spending.
Unfortunately, one of the biggest chunks of the federal budget–and, by definition, greatest contributors to the deficit–is pretty much out of his control: Medicare and Medicaid spending, i.e., healthcare spending. According to the Congressional Budget Office: “The federal budget is on an unsustainable path, primarily because of the rising cost of health care and the aging of the U.S. population.” Healthcare reform was supposed to at least start to address that; but then Congress got cold feet and 9 months of effort went flying out the window.
So here’s what I don’t understand. Everyone wants to shrink the deficit, right? And it appears that one of the most important ways to shrink the deficit is to reign in healthcare spending. As the CBO notes: “Addressing health care issues will be crucial to closing the nation’s looming fiscal gap—which is caused to a great extent by rising health care costs . . . If tax revenues as a share of GDP remain at current levels, additional spending for Medicare, Medicaid, and Social Security will eventually cause future budget deficits to become unsustainable.”
But it appears that we are loathe to do the upfront work and pay the upfront costs for healthcare reform that would, economists agree, eventually slow healthcare spending and reduce the deficit. At the rate we’re going, the CBO estimates, healthcare spending will make up 25 percent of the GDP by 20205 (in 15 years, people) and 40 percent of GDP by 2050–that’s only 40 years away! My youngest will be 54! (Of course, I’ll still be 32, but that’s a topic for another blog).
Now, I’m not the greatest at math, but even to me this makes no sense. The reality, people, is that someone, somewhere, always has to pick up the check. Will it be us or will it be our kids and their kids??
*This blog post was originally published at Debra Gordon's Musings on Medicine and Health Care*