Our health course not sustainable

Columnist Todd Dorman is on vacation.

There is no doubt that health care costs in the United States are excessive and continue to grow at an unsustainable rate. The Centers for Medicare and Medicaid Services (CMS) reports that health care costs in the United States grew from $28 billion

(5.2 percent of GDP) in 1960 to $2.2 trillion (16.2 percent of GDP) in 2007.

There many reasons why our costs are excessive. A complete discussion is beyond the scope of one article, so I will focus on the past involvement of government and proposed further governmental involvement.

Government subsidization of civilian health care began in 1930, when the Department of Veterans Affairs was founded. Medicare and Medicaid were enacted in 1965. The State Children's Health Insurance Program, or SCHIP, was created in 1997. Medicare Part D was established in 2003. Today, the federal and state governments spend

46 percent of our health care dollars, CMS reports.

Governmental involvement also has included regulations that have affected health insurance and delivery of health care. In 1942, Congress authorized tax-deductible, employer-purchased care plans. Other legislation included the Health Maintenance Organization (HMO) Act in 1973.

The goals of government have been laudable, to insure fairness and control costs, but have they been realized? Or, has government involvement worsened the problems it tried to address?

One cannot be certain whether costs would be more or less without past government involvement, but continuing the current course is not sustainable. The Congressional Budget Office reached the same conclusion: “Under current law, the federal budget is on an unsustainable path ... rising costs for health care and the aging of the U.S. population will cause federal spending to increase rapidly under any plausible scenario for current law.”

The Department of the Treasury estimates expenditures on Medicare, Medicaid and Social Security could consume all of federal revenue by 2080.

Unfortunately, the proposals in the U.S. Congress do not adequately address these long-term, fiscal concerns. The CBO's preliminary estimates of H.R. 3200 predict a further increase in the federal debt of up to

$1.042 trillion over the next 10 years.

One of the most disheartening aspects of the debate is that we seem poised to squander yet another opportunity to effect meaningful, and fiscally responsible, change.

I am not favor of the status quo. I do believe reform is possible and costs can be reduced if the problems are clearly understood and honestly addressed.

Dr. Christopher C. Peters practices with Iowa City Thoracic & Vascular.