editorial (2007-02)

The Grotesque Cost of the Nation’s Health

A crisis must first be perceived to be addressed

‘Gov.’ Wilder No More

The Grotesque Cost of the Nation’s Health

Healthcare costs have been out of control in America for so long now that it’s difficult to declare a crisis or determine when it began or where it is headed. The dollar figures, though, are sobering.

The costs of securing healthcare for Americans have been increasing at three times the rate of inflation. That should catch everyone’s attention, but it has yet to really sink in. The dollar amounts are more impressive. Although the final tally for 2006 has not been assessed, healthcare spending in this country surely reached the $2 trillion mark. That means that about $1 of every $6 spent in the United States last year went for healthcare. Healthcare is costing Americans four times as much as we spend on national defense. It represents 16 percent of gross domestic product.

By comparison, Germany spends a little less than 11 percent on healthcare, France a little less than 10 percent and Canada 9.5 percent.

In each of those Western nations, with airs of social consciousness and a sense of public obligation approaching or exceeding our own, the weight of healthcare costs and the anticipated increase are cause for economic groans.

And the upward spiral in costs shows no sign of relenting, given advances in medical science and technology and the demands of an aging population, especially in the United States.

The projection is that healthcare spending will approach $3 trillion around 2010 and $4 trillion in 2015. To paraphrase the late Sen. Everett Dirksen’s famously quoted remark: “A trillion here, a trillion there, pretty soon it adds up to real money.”

Just try to imagine how much our nation’s GDP must grow over the next nine years to meet that projected cost, with 16 percent of GDP going to healthcare. Such a staggering productivity growth curve can’t reasonably be met.

There was once the thought that nationalizing healthcare could both meet the needs of the nation’s people and be paid for, relatively painlessly, out of taxes. That suggestion looks preposterous today.

The costs themselves must be contained in some way. But how? Inefficiencies in providing healthcare could be remedied to some extent; there might be a limited opportunity to cut down on waste, outright fraud and inappropriate or patently excessive healthcare expenses; management lapses and administrative excesses could be curbed to some extent. But who could marshal the resources needed to conduct such vast reform? Who could attack those issues on a scale that would truly influence the entire healthcare industry? If not the federal government, then who?

When CharlesWilson, the General Motors president, was named Secretaryof Defense by President Eisenhower in the early 1950s, GM was the largest corporation in America in terms of its revenues. Wilson suggested then that he believed “what was good for the country was good for GM and vice versa.”

Does that mean that when the cost of providing healthcare benefits to its employees and retirees threatens to take GM to the brink of total collapse, the upshot in vice versa terms is that such a threat to the country now exists?  Has America finally reached a healthcare crisis worth addressing with all the resources at its command?

We can hope so. It becomes at that point a crisis in leadership, and we must look to the 2008 national elections to determine which candidates have the commitment to find the way to a solution.

‘Gov.’ Wilder No More

The state Senate Tuesday elected Sen. Ron Ramsey, R-Blountville, by a vote of 18-15, to succeed John Wilder, D-Mason, as its speaker. Wilder served in that capacity, which includes the title lieutenant governor, for 36 years.

It was time. It was past time, as the 85-year-old Wilder was beyond the point where consistent metal acuity was evident in his words and actions. But it carries with it a threat of potential partisanship and a challenge to Speaker Ramsey that may be difficult to meet.

All 17 Republican senators and Democrat Sen. Rosalind Kurita of Clarksville voted to make the change in speakership, anointing Ramsey as the first Republican speaker of the Senate in 137 years.

Wilder’s legacy, despite his advanced years and questions about his mental capacity to perform in that high office, was one of bipartisanship in doling out committee chairs. That practice kept some East Tennessee Republicans content with committee assignments and allowed for broad representation in the Senate for the Republican minority. It also kept Wilder elected speaker when the Democrat majority dwindled.

Now, with the GOP in the majority, treatment of the Democrat minority will be the big question facing Lt. Gov. Ramsey. It may be tempting to take all the spoils, but Ramsey hadn’t ought to see it that way.