Tuesday, March 24, 2009
The Duke basketball coach and most other Americans believe that President Obama is unwisely diverting his attention from the sick economy.
In the case of Coach Mike Krzyzewski, the unhappiness is part personal. Obama recently took time out of his busy schedule to predict, among other NCAA tournament outcomes, that Duke would not make it into the Final Four.
"The economy is something he should focus on, probably more than the (tournament) brackets," Krzyzewski advised.
And what about the 55 percent of Americans who told pollsters that Obama is doing too much? They see his tackling of health care, education and energy -- on top of fixing the economy -- as issue overload.
And the president's political foes are happy to stoke those concerns: They would fight his agendas were the American economy floating on Cloud Nine.
The public's sense of poor prioritizing rests on a flawed assumption -- that fixing the economy can be separated from health care, education and energy. These issues all go into the big enchilada of American competitiveness.
If Obama ever has to throw any of them off the agenda island, he must ensure that health-care reform remains a survivor. The inability to afford needed medical treatment is among Americans' most primal economic fears. (Ask think tanks why, when they sponsor polls on issues Americans worry about, they list "the economy" and "health care" as separate items. They'll respond that they don't know why.)
In the bigger picture, soaring health-care costs are busting federal and state budgets. They put Americans at a comparative disadvantage to foreign companies whose governments curb medical spending.
The Business Roundtable has found some remarkable disparities in health-care spending and quality between the United States and four other leading industrial democracies (France, Germany, Japan and the United Kingdom). 1) The Group of Five's employers and workers spend 63 percent of what the United States does on health care. 2) American workers are 10 percent less healthy than the G-5 average.
A most amazing number is $8,000. That's a recent estimate of how much America spends on health care for every man, woman and child a year. It is twice the average of other rich countries. And the $8,000 includes the 47 million Americans with no insurance. The other nations cover everyone.
How can America close this gap? For starters, it can curtail unnecessarily expensive care. As a first step, the administration put $1.1 billion in the stimulus package to compare the success of different drugs and treatments for the same illness.
Of course, interfering with anyone's revenue stream will ignite a campaign to kill off real health-care reform. But making rules for what gets covered is the only way to contain costs. Private insurers do it. All other industrialized countries do it.
Consider this: America could set its health care spending 50 percent higher than the rich-country average and still see enormous savings. This doesn't sound like much of a sacrifice for the American health-care consumer.
The challenge for reformers will be gaining the trust of Americans happy with their coverage. Many people fear that a national plan would compromise the quality of care they've come to expect. The time to establish their trust is right now, while the Obama administration is still young and enjoying much good will.
In sum, the president's push for health-care reform amid economic crisis is not a symptom of any attention-deficit disorder. It is making good use of political momentum while it lasts.
Health care consumes 17 percent of the U.S. gross domestic product, which is hardly small change. If fixing health care isn't part of setting the U.S. economy upright, then what is?
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