Health care: The stealth revolution
An odd coupling of governors and CEOs lead the charge
WASHINGTON (CNN) -- Lost in the fray of the public debate over Terri Schiavo, steroids and Social Security, a political revolution may be quietly taking hold this year, far away from the halls of Capitol Hill.
Health care as we know it -- from prescription drugs and co-pays to knee surgeries and annual check-ups -- may be undergoing a stealth, but dramatic, transformation led by an odd coupling of governors and CEOs.
From Florida's Jeb Bush, a Republican, to Tennessee's Phil Bredesen, a Democrat, governors across the country are reassessing the nation's largest health care program, Medicaid, which provides insurance for 50 million low-income people -- about one out of six Americans.
Health care costs have dramatically increased in recent years and Medicaid now consumes a significant portion of many states' finances.
For example, Florida spends approximately 20 percent of its budget on Medicaid -- more than it spends on higher education, police and fire services combined.
Faced with spiraling costs, many governors have started applying for and receiving new federal waivers to make dramatic changes -- usually cuts -- in their health care plans.
Since these Medicaid cuts affect the poor and disenfranchised, they are taking place, for the most part, below the public's radar screen.
Cutbacks in health care benefits, however, are not limited to the public sector. Many CEOs in the private sector are reviewing their companies' health care plans.
While this trend has been growing to some extent over the past decade, when GM, the nation's largest single private health care provider, recently announced a renewed effort to negotiate a major cutback in its generous health care plan with its main labor union, it sent a massive signal to the rest of corporate America that financial health may mean dramatic curbs in health care benefits for current workers and retirees.
While many Americans may not immediately feel the effect of these Medicaid and corporate changes this year, it is possible that 2005 will be a tipping point in which the nation -- from corporations to state governments -- embarks upon a much more austere approach to health care services.
A little more than a decade ago, Bill and Hillary Clinton famously tried and failed, at significant political cost, to change the health care system with a broad congressional program.
Since then, despite skyrocketing costs that have yielded relatively poor results (the United States spends almost twice per person what Canada spends, but Americans have a shorter life expectancy and mortality rate) and a staggering 45 million uninsured, presidents and the Congress have refused to take coordinated, comprehensive action.
But with changes that seem to be gaining steam in 2005 and with Baby Boomers beginning to retire in 2011 (which will put even more strain on the nation's health care system), the next president may not have the luxury of sitting on the sidelines.
At some point, an administration will have to take on the difficult task of balancing the vital importance of the nation's health with financial viability.
Indeed without any significant new action, a new University of California study estimates not only 11 million more uninsured people by 2013, but also higher costs and less service (eye check-ups, medicines and critical surgeries) even for those who do have health insurance in the years to come.
Even before such coordinated action is forced, or simply taken, governors and CEOs will have to consider how decreased health care services will affect U.S. productivity and competitiveness in the long run -- not to mention the health and well-being of future generations.
Meanwhile, America sits embarrassingly low on the World Health Organization's 2000 ranking of world health systems' performance -- in 37th place, behind Costa Rica and ahead of Slovenia and Cuba.
So this year, while Social Security and other issues are heavily debated on Capitol Hill, keep your eye on the quiet revolution going on in health care.
From heart medication to cancer treatments, those changes could even more dramatically affect your life in the decade to come.
