Nation’s Health System To Encounter ‘Major Crises,’ Roll Call’s Kondracke Says

Morton Kondracke writes in his Roll Call column that the health care system is about to encounter what the National Coalition on Health Care calls "a perfect storm." Kondracke cites a variety of "major crises" that are "unfolding over health care costs, delivery and quality," including:

• Lack of political will. Kondracke writes that after former First Lady Hillary Clinton's "fail[ed]" health reform package in 1994, politicians became "scared" to think "comprehensively about problems that have only festered in the meantime." He writes that this year, Congress is also unlikely to pass any health legislation besides that contained in a bioterrorism package.
• Medical errors. Kondracke cites Institute of Medicine statistics from 2000 that found that between 50,000 and 90,000 people die from medical mistakes each year.
• A focus on the bottom line. Kondracke writes that 1997 federal cutbacks to hospitals have caused facilities to "cut back on care and demanded that nurses work overtime, causing them to leave the profession in droves." Meanwhile, insurance companies "are raising premiums, dumping Medicare services, denying benefits and forcing doctors to see more patients in less time."
• NIH funding. Kondracke says that President Bush "has backslided on his promise" to double the NIH budget. According to Kondracke, Bush "again may give NIH less than a full boost because it allegedly can't spend what it has." However, "it might help," Kondracke writes, if Bush would name a new NIH Director.
• The uninsured. Kondracke says that the "main burden" facing the health care system is access to care. A study released by the National Coalition on Health last week predicted that health insurance costs will rise 34% between 2000 and 2002, causing six million America to lose coverage and increasing the number of uninsured to 45 million. He says that the coalition study shows that the "country needs comprehensive reform of its health care delivery system, starting with an insurance system that covers everyone." Kondracke concludes: "The coalition is not recommending any particular system -- Canadian, employer-based or private -- but it advocates that work be started on one soon." While Congress this year is "doing nothing ... [s]mart politicians should get the message" (Kondracke, Roll Call, 11/19).