by Bradley Parsons
Staff Writer
President George Bush used his Tuesday night State of the Union address to call for reform of America’s ailing health care industry. Dr. George Bartley, the CEO of Mayo Clinic, Jacksonville, hopes those are the opening words of a long conversation.
Bush wants a health care system driven more by consumers. His plan would expand individual health savings accounts and create tax breaks for the uninsured to buy coverage. Critics, many of them congressional Democrats, say the plan would leave the sick and the poor fending for themselves. They advocate more government involvement in health care.
Bartley’s remedy treads the middle ground. His idea for market-based universal coverage, discussed Tuesday at Jacksonville University’s monthly Economic Round table, espouses individual responsibility for health insurance. Employers could help pay premiums while the government would contribute through continued Medicare and Medicaid funding, tax breaks on additional coverage and funding for medical research and education.
“This plan should be palatable to both (political) parties,” said Bartley.
But before any plan can be adopted, Bartley said the country needs to have a very public discussion about what kind of health care system it wants. Quality plans are weighed by three criteria: quality, accessibility and cost. Realistically, America can only hope to score high marks in two of the three, he said.
Currently, quality is generally good but inconsistent. Health care is accessible to Americans provided they have money, said Bartley. The rapidly-rising cost causes the most concern.
Health care is one of the biggest expenses in the government’s budget, said Hassan Pordelli, a professor of economics and finance at JU. Health costs account for about $1.9 trillion annually, meaning about 16 percent of America’s Gross Domestic Product goes to health care. That’s more than is spent annually on food or housing. Bartley expects that share to grow to 18 percent by 2013. The government currently picks up the tab for about 60 percent of those costs through Medicare, Medicaid and tax breaks.
Even so, the health care burden is growing heavier on individuals. As costs outpace the Consumer Price Index, employers are scaling back the coverage they pay for and shifting that cost to employees. And government cuts to Medicare reimbursements mean non-Medicare patients end up paying more at facilities like the Mayo Clinic, said Bartley.
The Mayo Clinic has to make up the money lost to Medicare cuts because it pays for research, new technology and capital improvements, he said.
“Our Medicare rates are getting cut and the CPI is going in the opposite direction,” said Bartley.
Health care costs have become a particular drag on small business employers, many of whom hire part-time workers to avoid paying for benefits, said Pordelli. Mid- to low-wage workers are paying more out of each paycheck for their coverage. Many entry-level workers do without the costly coverage, making up a significant portion of America’s 40 million uninsured.
Those numbers have some people pining for nationalized health care similar to systems in England and Canada. Jeffrey Goldhagen, the former head of the Duval County Health Department, suggested the so-called single-payer system to Bartley.
Bartley said he wasn’t ready to advocate such a system, explaining the government already pays much more of the country’s health costs than most people realize.
Increased government involvement, while cheaper for patients, would also carry the risk of dulling the market for health care consumers, said Pordelli. Increased competition among providers would likely produce better innovation and quality in health care, he said.
Pordelli noted that Canada’s nationalized system is cheaper for its citizens. But many Canadians come to America for treatment of serious illnesses, he said.
The government can make its greatest impact by forcing a conversation about what kind of health care system Americans want, said Bartley. Only then can steps be taken toward a solution.
“What I hope to see from our leadership is the courage to put the real issues on the table and to push the debate,” he said.