UW News

October 24, 2002

Scary news in Oct. 31 lecture on health care

Some people believe we’re in the middle of a perfect storm in health care, but we’re not going to drown anytime soon. No, says Aaron Katz, the experience is more like sitting in a house, listening to the waves repeatedly crash against the cliff outside.

“There’s this noticeable but slow erosion,” he says.

Katz is in a position to know what he’s talking about. He’s the director of the UW’s Health Policy Analysis Program, and he’ll be speaking at the Retirement Association’s fall membership meeting on Thursday, Oct. 31. The speech, titled “Our Health Care System is Unsustainable: Now What?” will be at 2:30 p.m. in the Walker Ames Room.

If what Katz is saying is true, this is an issue that every citizen should be informed about. “We cannot sustain the current health care system with the resources we have, and I don’t think there is the political will right now to do anything about it,” he says.

Like most crises, this one didn’t happen overnight. Over the course of the 1980s and 1990s, Katz says, Washington state expanded eligibility in a variety of health care programs and created a special program, the Basic Health Plan, for what are generally called the working poor. That put the state at the forefront of progressiveness, but then the recession arrived just as a number of tax cutting initiatives passed. Suddenly the resources to support the health programs were in short supply.

“So if we look at the state budget today, what we find is that health-care spending has gone up three times as fast as other spending,” Katz says. “And as a result it is beginning to crowd out other things the state invests in — for example, K-12 and higher education.”

University employees will be facing higher costs for health care in January, and they aren’t alone. Katz says the cost to businesses for health-care coverage has gone up every year in the last few years — for the same coverage — and employers have been forced to either pass more of the cost to their employees or to reduce benefits. Some have dropped coverage altogether.

The spiraling costs have in turn led to the move toward efficiency and managed care. “It’s always better to be efficient,” Katz says, “but what I hear from friends and colleagues in health care is that it’s getting to be an assembly line and you can’t provide good care on an assembly line.”

In the end, patients aren’t happy, doctors aren’t happy, businesses aren’t happy. Katz says we’ve ended up with a health-care system “that doesn’t seem to work for anybody,” despite the fact that we pay more for it than any other country.

So what’s to be done? Katz believes that’s a political question, but the answer won’t come from politicians, who aren’t eager to involve themselves in a complicated and messy issue.

“One of the things that’s needed now is for people and organizations who recognize the critical situation we’re in as far as health care is concerned to help generate the political leadership to look at this thing seriously and try to solve this problem,” Katz says. “This is a particularly good time because there’s an election coming up. Politicians tend to be very receptive to people who might or might not vote for them. And they tend to be even more receptive to organizations who represent a lot of votes.”

Katz thinks the 2004 election offers even more opportunity for bringing health care to the top of the political agenda, given that a president will be elected that year. In fact, he hopes that health care will be one of the central issues of that election.

“It seems to me that the notion of life, liberty and the pursuit of happiness is the notion of opportunity,” Katz says. “And having access to necessary medical care seems to me part of that idea of opportunity. To me that sounds more like a public good than a market commodity. So I guess I would say government — our political representatives — need to take more responsibility for guiding the health-care system than they have.”

Although the lecture is part of a UWRA membership meeting, non-members are welcome to attend subject only to space limitations. Retirement Center Director Pat Dougherty asks anyone interested to call the center at 206-543-8600.