Wednesday, Sep. 01, 2010

Health costs are our fault

Many of those insured by Blue Cross Blue Shield of North Carolina have likely been doing some fist-shaking lately.

The state's biggest provider of individual health insurance just announced that it will seek a rate hike of about 7 percent. That increase, the lowest in several years, wouldn't seem so bad but for a couple of factors - the down economy means that it will far outstrip inflation; some Blue Cross customers will see increases well in excess of the average hike, up to 30 percent or more.

So, it would hardly come as a surprise if a few fists have been shaken in the general direction of the insurer and its high-paid executives.

Depending upon their political proclivities, some customers might have also tossed some choice comments Barack Obama's way, blaming the president's health-care reform for the price increase. (Never mind that rates rose even faster before health-care legislation passed. Last year's increases averaged 11 percent.) Others might have cursed Congress for its inability to pass a health-care plan that included a public option to compete with private insurers.

Blue Cross was happy to invoke health-care reform as one cause of the rate hikes, saying volatility in rates would continue as more provisions of the law take effect over the next four years.

Interestingly enough, back in March, new Blue Cross chief executive Brad Wilson called the plan "a step in the right direction." Those comments came after Blue Cross and other insurers lobbied to successfully kill the public option.

Still, bashing Blue Cross might be pointless.

Wilson is correct when he says "the only way to make premiums affordable over the long term is to get soaring medical costs under control."

If Blue Cross deserves any blame for those soaring medical costs, then so do all of us.

As seen last year and earlier this year during the debate over health-care reform, no one - not insurers, consumers, doctors, hospitals, big business, politicians, Republicans, Democrats, tea partiers or liberal activists - is really interested addressing the real problem.

The real problem is that we, as a society, are spending more on health care than we can afford.

Because government is such a big provider of health care, medical spending is driving deficits at the federal level. It's driving tax hikes and the erosion of spending on education at the state level. It's causing tuition hikes, bigger class sizes and early prison releases. It's affecting crime rates and academic achievement gaps.

And every day, the increases in medical costs become more unsustainable.

But when "rationing" is a dirty word, and people like Wilson and Obama can't say it because we won't let them, you can't have a real debate. And you can't have a real debate when a crowd - maybe two-thirds of them receiving health care through a government-created program - cheers on some charlatan yelling, "Hey government, hands off my health care."

And health-care reform doesn't live up to its promise. And we live in a world of our making.