Congress must find the will to make health care more than a slogan

When I wrote editorials for this newspaper in the mid-1980s, Ronald Reagan was busy trying to control what the federal government spent on health care — cutting Medicare, shifting Medicaid to state and local governments with block grants, and trying to induce more competition.

The result? Health care costs began a rapid rise, many hospitals and clinics closed while others consolidated into large groups, and many people lost their coverage.

Health care costs were not rising because of tinkering in Washington, but because of new drugs and technologies, the aging of the Boomers, chronic diseases and obscene administrative waste.

The passage of the Affordable Care Act (ACA) under President Obama did things people liked — ending denial of coverage for pre-existing conditions — and things they didn’t — the individual mandate. However, it did not fundamentally change our employer-based, fee-for-service model of health care.

The American health care system remains inefficient, expensive, mired in Kafkaesque complexity, and delivers poorer outcomes than in other industrialized nations. Yes, at the high end, American health care is second to none, but that high end is largely reserved for those with robust insurance coverage (often because of union contracts) or significant wealth.

Thus, the current narrow debate in the Congress whether to extend subsidies for the ACA or to create an entirely new structure of health savings accounts will do little to solve any of the fundamental problems of the system.

It has often been said that if we were going to design a health care system from scratch, it would not be what we have. It burdens the economy in multiple ways, is an administrative nightmare, and leaves millions without coverage. Consider:

• America spends 17.6% of its GDP on health care. In comparison, Germany is second at 11.5%.

• Although figures vary, America spends about 25% on administration. Germany spends 4-5 percent.

• American doctors spend anywhere from a fifth to a third of their time on administration instead of treating patients.

• Two-thirds of Americans who file for personal bankruptcy cite medical costs.

• About 8 to 9% of Americans lack health insurance — about 25-26 million people.

• America is short about 52,000 primary care physicians and there are shortages of nurses and other personnel, and the shortages are growing.

• By 2033, the Medicare trust fund will be depleted, and incoming revenue will only cover 89% of projected costs.

Health care costs are at the very heart of the affordability issue, which — by the way — is not a hoax.

Given the above, shouldn’t the current state of health care in America be, if not a crisis, a serious problem that the administration and the Congress should make a good-faith effort to address?

The president has announced a deal with drug companies to lower some prescription drug prices and wants to cajole health insurance companies to lower prices. However, he says the Affordable Care Act — despite covering a record number of participants this past year — will die of its own accord. As for the proposed health savings accounts, he has taken a hands-off approach and proposed no legislation.

As we head into the New Year, many will make resolutions about their health — to eat better, exercise more, etc. Many of those resolutions will fall by the wayside by early February. Politicians often promise to “fix” our health care system, but those “resolutions” also evaporate quickly.

Serious people know only a bipartisan effort within the Congress and strong presidential leadership could have a chance of succeeding in tackling such an immense task. Few think such a thing is possible in the current political environment.

As such, Make Americans Healthy Again (Again?) will largely remain just a slogan.

• Keith Peterson, of Lake Barrington, served 29 years as a press and cultural officer for the United States Information Agency and Department of State. He was chief editorial writer of the Daily Herald 1984-86. His book “American Dreams: The Story of the Cyprus Fulbright Commission” is available from Amazon.com.