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# Health Care Reality: Change is a Math Formula

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If President Obama succeeds in his quest to reform America's health care system -- an "if" that gets if-ier every day -- it will be because the administration finally embraces the fundamental rule of change: Change is a math formula: C=Co(SQ)>R(C). The formula reads: Change happens when the cost of the status quo is greater than the risk of change. The way to win the debate on health care reform is to drive up the perceived cost of the status quo.

It may be that the administration is starting to do the math. In his recent health care reform press conference President Obama used the change formula. "If somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care and that is by far the biggest contributor to our federal deficit, I think most people would be opposed to that," President Obama said. "Well, that's the status quo."

It was a nod in the right direction, but no more than a nod. As soon as the president was done with that passage, he went back to explaining how his health care plan would work. Back, in other words, to the wrong side of the equation. As long as the debate focuses on the perceived risk of change, change loses. For change to win, every answer to every question about health care has to begin with a precise calculation of the high cost of the status quo.

The simple reason for that is that, for the most part, Americans with health care coverage operating within the accepted norms of the existing system don't feel that system failing. If there is a "health care crisis" it isn't their health care crisis. What they need -- what we all need -- is a detailed, understandable explanation of the high cost of the status quo. We need it in economic terms and we need it in human terms. Then and only then, after we've come to appreciate the high cost of the status quo, will we be ready to accept the risk of change. In fact, if the president and his team do their jobs right, we'll welcome the risk of change as an improvement over the current unworkable system. We'll finally be confronted by its unsustainable economic costs and its unimaginable human costs.

Take the economic side first. There's a simple reason why corporate America has embraced health care reform: companies are tired of bearing the high cost of a system that saps their ability to compete in the marketplace. At GM, the sick joke used to be that the company made and sold cars to be able to pay for its employees' health care costs. Starbucks, long regarded an exemplary employer in the convenience food and beverage industry, routinely pays more for health care benefits for its workers than it spends on coffee beans for its customers. Anyone who's worried that health care reform could cost American jobs needs to take a hard look at the jobs we routinely lose now because our companies have to absorb health care costs that our global competitors simply don't have to pay.

At the individual level, the economic burden of the U.S. health system is also untenable: Americans spend about \$6,500 per person per year on a health care system that now takes up 16 percent of the U.S. economy. But when it comes to results, all that spending doesn't measure up. The United States ranks number 41 in the world in life expectancy, below Cuba, Costa Rica, the U.K. and Germany, among others. When it comes to the category of child well-being, the U.S. ranks number 20 in the world, behind such nations as Greece, Poland and the Czech Republic. We're paying a lot and we're not getting much for our money. And it's only going to get worse.

At the same time, we need to hear stories of the human costs. Americans will listen to their wallets and pocketbooks first, but as a people we're not immune to chilling stories of human tragedy. Take the story of a 12-year-old boy named Deamonte Driver who lived in Prince George's Country, Maryland, a few miles from the nation's capitol. As reported in the Washington Post by Mary Otto, in 2007 Deamonte Driver died of a toothache. Here's what she wrote: "A routine \$80 tooth extraction might have saved him. If his mother had been insured. If his family had not lost its Medicaid. If Medicaid dentists weren't so hard to find. If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth."

Instead the bacteria from the abscess in Deamonte's tooth spread to his brain and killed him. That's just one human story about the high costs of the status quo -- a story that took place not far from where today's debate on our disfunctional health care system is going on. It makes the same point as the economic data. The current system is broken. It is only getting worse. It costs too much and delivers too little. It undermines our nation's companies. It allows 12-year-olds to die of tooth disease. It is a national crisis.

All of a sudden the risk of change looks a lot better.