I have blogged on many occasions regarding the fact that Congress solved for the wrong problem enacting health reform. The problem is the exponential rate of cost increases of American Healthcare. This is the same problem plaguing other countries such as France Germany and the U.K. So it is not just an American but a universal problem which if not addressed will lead to devastating effects on the world economy.

In their article the authors suggest that Massachusetts and Tennessee provide recent examples of cases where insurance coverage expansion has led to cost increases instead of savings. Tennessee had to scrap it's plan after costs tripled from $2.5 billion in 1995 to $8 billion in 2004.In Massachusetts the authors describe, "the Special Commission on Health Care Payment System has produced payment recommendations in the wake of passing an individual insurance mandate and coverage expansions. But the commissions' recommendations have not yet been enacted into law,so overall costs,which are growing 8 percent a year in Massachusetts,have not slowed". And that's the point, the exponential growth in cost is not slowing in Massachusetts and will not slow  nationally either.

"What is the bottom Line? Removing the potentially unrealistic annual savings,reflecting the full costs of implementing the programs,acknowledging the unlikelihood of raising all of the promised revenues,and preserving premiums for the programs they are intended to finance produces a radically different bottom line. The act generates additional deficits of $562 billion in the first 10 years. And because the nation would be on the hook for two more entitlement programs rapidly expanding as far as the eye can see,the deficit in second ten years would approach $1.5 trillion". 

I've also said on these pages I'm all for covering all Americans with health insurance but not at the expense of further devastation of our economy. The only way out is to address the cost and quality problems in American healthcare and although there are some programs in the health reform legislation that attempt to address these issues it will be years in piloting and studying and publishing before anything sticks.We need to change the delivery of care now not in ten years. We have great examples published on these pages and elsewhere of where radical changes are happening and how they are being implemented. Real reform will only happen when the government wakes up to this fact and moves in the direction to support this activity, by paying differently and releasing the Medicare administrative claims data so we create comparative performance data across all health systems.