Medicare and Money

Medicare, which provides health insurance to Americans 65 and older, will face a financial crisis. In the 2008 report to Congress, the Board of Trustees estimated that the program's hospital insurance trust fund could run out of money by 2017. This is a problem. Despite the health care legislation being discussed right now, it's not clear that government health insurance can remain solvent in the near future. Any new health care bill must account for long-term planning. Where is our money going to come from? How can we keep costs down? Can we guarantee that this major health care overhaul will remain stable in the future?

I feel that a solution to health care must encompass wide-reaching policies in different fields. For example, to keep Americans healthier and control costs, we need to target chronic diseases that are rising in prevalence like diabetes and obesity. To make headway on problems like that, we need to step out of the health care box and push for policies in other arenas. For example, how much does the government subsidize commodity food products like corn? Food companies have a huge incentive to produce corn products including high fructose corn syrup because the infrastructure and government favors this. But high fructose corn syrup products, fast food, soda, indestructible sugar-laden foods are all responsible for driving up our health care costs and increasing the prevalence of obesity and diabetes in children. If government is to take a stance on health care costs and if we are leaning towards a role of bigger government influence, then it needs to subsidize fruits and vegetables, not candy and chips. We need to favor local small markets rather than multinational corporations.

In the same way, we need to figure out how to prevent people from starting to smoke; prevention is a lot easier than intervention, and cheaper. There is a fair amount of research and a number of medications that help people quit tobacco, but what we need is research figuring out how we can stop people from starting in the first place. If we want to keep health care costs down and people out of the hospital, we need investigate how people make those personal choices.

We don't want to tell people what to eat or how much to exercise or whether they can smoke or not. We don't want to interfere with their personal decisions and free will. But if we're serious about taking on the responsibility of health care and if our funding is not inexhaustible, we need to put pressure on people to stay healthy.

How much money do we spend on mammograms and prostate cancer screening? How much money do we spend on getting kids to eat vegetables and exercise? Which, in the long run, is most cost-effective at increasing health? I don't know what the answer is, but I want to suggest that if we take a stronger stance on prevention, even if it means more government, we can get people to be healthier and perhaps save on our health care costs.