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SCOTUS and Health Care Reform: We Are Arguing Over the Wrong Things

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A colleague of mine, Kathleen Benanti, was hit by a drunk driver in 1992. The whiplash crushed her neck's C6/C7 joint, creating shrieking levels of pain. Unfortunately, the driver didn't have car insurance and Kathleen didn't have health insurance, so all she could manage was paying for an X-ray, which was inconclusive. And she couldn't afford treatment.

She was in such pain that she couldn't move her head up, down or sideways, which made using the phone at work quite difficult. Absent any insurance, doctors told her to wear a head set, and sent her on her way.

But when she landed a job at Morgan Stanley, with its very comprehensive health insurance program, doctors were suddenly eager to help. They suggested a litany of tests, so many that Kathleen turned most of them down. Finally, she found a doctor who didn't see her as a revenue stream, but as a whole person in intense pain. He did one X-ray and an exam, then cleared his schedule so he could do her surgery immediately.

Today, Kathleen is fit, healthy and happy. She works with me at the Comeback America Initiative, and helps us advocate for a health care system that is affordable, of high quality, and sustainable. Her experience reveals what the experts already know: America doesn't have a health care system.


The reason is simple: instead of a health care system, we have a "sick-care" system that provides perverse incentives and inadequate accountability.

A real health care "system" would focus on health and result in efficient and effective utilization of available resources. But our approach provides few incentives for physicians to practice preventive medicine, which would reduce the need for "sick" care in the first place. This misaligned incentive system encourages costly and sometimes unnecessary procedures that drive up our health care bill, and can even harm patients.

And as our nation's former top auditor, I know firsthand that if there is one thing that can truly bankrupt our country, it is out of control health care costs. Believe it or not, almost half of all healthcare purchased in the U.S. is already financed by the government, an amount that is growing fast and is unsustainable. Nonetheless, we achieve below average societal heath care outcomes despite spending about double per person as compared to other major nations.

No matter what you think of the nation's new healthcare law, its primary purpose was to insure about 48 million more Americans rather than to reign in out-of-control costs. Even after health care reform, we still have trillions in unfunded Medicare and other health care promises that are growing daily.

Regardless of the Supreme Court's decision on the constitutionality of the new health care law, our health care system is in need of radical, reconstructive surgery. Without major reform, health care could bankrupt our country. And it doesn't do enough in connection with key incentive and accountability issues.

Unfortunately, meaningful health care reform is not a high priority or "sexy" issue. There are no celebrities making cool viral videos about the need for creating a real and sensible health care system. So voters don't know the details, and they aren't pressuring politicians to take the steps that health experts know are essential.


You can do your part. Watch the video I've posted about smarter health care. Then take a moment to tweet about the video, or share it on your Facebook page. And please take the time to learn more -- once we all know the facts about health care, Congress won't be able to continue to duck its responsibility.

David M. Walker is CEO of the Comeback America Initiative and former comptroller general of the United States. His "Myth of the Month" vlog on YouTube this month focuses on the myth that America has a health care system.