Basic care

When will we face the health-cost issue

As Clarke Cochran observed in these pages (“The Health-Care Issue,” September 24), debates about reforming health care are back with a vengeance. Both major presidential candidates are offering their laundry lists for change, but a healthy skepticism seems in order. If the partisan reactions to recently proposed increases of 17.4 percent in Medicare premiums are indicative, both Democrats and Republicans remain in a state of denial about the scope of the challenges ahead. Republicans are correct that the premium increase is the “automatic” result of a formula devised as part of a 1997 deficit-reduction bill. They are wrong to single out Kerry for supporting that bill, since eighty-four other senators, including most Republicans, voted for it. Democrats are correct to note that the projected increase represents a 56-percent rise in Medicare premiums since 2001. They are wrong to focus narrowly on efforts to block the current increase without facing squarely the need to rein in health-care costs more broadly.

The statistics that Cochran rehearsed about rising costs and rising numbers of those without insurance are familiar and depressing. Yet unless some sort of overlapping consensus can be developed at the level of shared social vision, debates about policy details are likely to remain mired in Foggy Bottom rhetoric. Why do we seem to lack the political will to provide universal access to basic health care-a...

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