Last week, I was fortunate to participate in a three-day seminar in the Washington, D.C., area through a fellowship from the Knight Center for Specialized Journalism at the University of Maryland. The seminar brought together 21 journalists from newspapers around the country to examine the issue of health care reform. The fellows were selected on the basis of work submitted, and the newspapers represented ranged in size from giant dailies like The Arizona Republic and The Philadelphia Inquirer (both over 300,000 circulation) to your own twice-weekly Transcript-Bulletin (8,500 circulation).
The seminar gave our group rare access to senators and congressmen, leading health care industry analysts, world-class academics, policy directors and presidential campaign advisors. It also gave us an opportunity to bounce story ideas and ways of improving our health care coverage off colleagues in the field.
Health care has become the No. 1 domestic issue for voters as we head into a presidential election year, and it will likely become the biggest reform issue of our times. The health care system impacts the lives of every person in our country, and yet the scope and complexity of its problems seem at times beyond an ordinary citizen’s ability to untangle and comprehend.
What I was able to gather from my time in Washington is that our system is failing on three levels: cost, access and quality of care. For the last 40 years, our nation’s health care spending has outpaced the rate of GDP growth by 2.5 percent year over year. That’s unsustainable for the government, individuals and businesses. General Motors now spends more for health care coverage for employees than it does for steel, and Starbucks spends more for health care than it does for coffee beans. If those trends continue, it will be very difficult for U.S. companies to stay competitive globally.
We aren’t faring much better on the access side of the equation either, with 47 million Americans going without health insurance. That’s morally disgraceful for the wealthiest nation in the world. And that huge uninsured bloc means increased premiums for individuals with health insurance. It also means we have a large segment of the population who lives in fear of getting sick and is vulnerable to price gouging by hospitals and doctors because they have no large insurance company to negotiate on their behalf.
In terms of quality of care, most of the experts I listened to said America is a great country in which to see a specialist once you’re critically ill, but not a particularly great place to avoid getting ill in the first place. With a roughly 80-to-20 percentage split of specialists to general practitioners, little emphasis on preventative care, and many more financial rewards for treating patients at the critical end of the spectrum, we have some of the poorest quality outcomes in the industrialized world. In fact, the World Health Organization ranks the U.S. health system 37th among nations. What’s more, we pay two and a half times more for mediocre care than anyone else in the world, according to Princeton economist Uwe Reinhardt.
Part of the reason quality is slipping, particularly with regard to medical errors, is that there’s not enough comparative data being exchanged between hospitals or being made available to the public. Many experts would like to see hospitals follow the model of the Federal Aviation Administration, which makes public as much data as possible from every crash, malfunction or near-miss in the hopes of improving the safety of air travel. No one I talked to, however, was optimistic hospitals would follow suit given the litigious pressures they face today.
Despite the monumental challenges of reforming such a complex tangle of vested interests, reform is moving forward on several fronts. In the last two weeks alone, Governor Huntsman and Sen. Bob Bennett have put forward separate plans to mandate individuals purchase their own health insurance. Bennett’s bill, called the Healthy Americans Act, is co-sponsored by Sen. Ron Wyden, D-Ore., whom I met in Washington. It’s an early shot in a barrage of plans that will be touted next year, particularly by presidential candidates. Perhaps that’s as clear a sign as any that Americans are demanding health care reform now.
I’d like to think my time with the Knight Center made me better informed on health care, but I probably learned just enough to realize how uninformed I am. Fortunately, the trip also made me curious and resolved to improve the newspaper’s coverage of an issue that affects every man, woman and child in Tooele County. I’d like to hear your personal health care stories — positive or negative — or even ideas for stories, and we’ll try to incorporate them into future articles. As always, please let us know if you feel there are ways we could do a better job of covering this important issue.