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Posted From Chicago

Three days until we hit the debt ceiling and the art of cash management for the federal government becomes a really tricky deal…

Meanwhile, our leaders – with a small “L” – are scrambling to find a solution. As of this writing, on a beautiful cool Sunday afternoon in Chicago, the operative status report seems to be impasse.  While an immediate default will probably not occur, those who predict that there will be no serious consequences are smoking something that is probably illegal in this state. 

9780983995005_p0_v1_s260x420OK, feeling good?  Let’s talk about some positive news.  DFW journalist Steve Jacob’s interesting book Health Care in 2020 is chock full of some information that will send even the most optimistic  members of the “everything will work out crowd” to the nearest bar for serious medication.

Set aside for a moment the Washington silliness and consider these factoids from Jacob’s research:

  • By 2020, 40 percent of the nation’s doctors – members of the Baby Boomer generation -–will reach retirement age just as all of their fellow Boomers become eligible for Medicare and gradually become more robust consumers of healthcare.
  • Medicare and Medicaid costs will become 40 percent of the government’s projected increase in spending.
  • Out-of-pocket spending for healthcare – thought to be manageable for a family  of four at 10 percent of household – will jump to 17 percent. (Based on our current wage stagnation for the middle class, that is even more disturbing.)  Today, 40 percent of American households struggle to pay their medical bills.
  • 90 percent of Americans lack basic health literacy (sort of complicates the notion that population health management will help us reduce costs).
  • An employee survey found nearly 9 out of 10 lacked an understanding of the value of preventative  services, and more than half said they have “no motivation to stay healthy.”
  • Nearly four out of 10 American deaths are attributed to four behaviors:  tobacco use, diet, physical inactivity and alcohol abuse.
  • 26 percent of all Americans classify the preparation of food and drink as a “moderate exercise activity.”
  • About 30 percent of medical care today has no benefit to the patient.

I recommend that if you are seriously interested in healthcare reform, you take some time to review Jacob’s work.  It is an eye-opening, challenging bit of research that provides important context for the debate on how we should work to reduce costs, improve safety and provide a reasonable safety net for the least among us in society.