Demystifying the US Health Care Reform Debate


MANY OF US have become increasingly perplexed by the current US health care reform debate.  And that is understandable.  Exaggerated by partisan politics and media hype, issues that are complex and personal to begin with have become distorted and disguised, making the policy proposals being discussed in Congress all the more challenging to understand. 

Against the backdrop of an increasingly complex national debate, NYU Wagner Professor John Billings successfully honed in on the key problems facing US health care. On October 7, 2009, at the Wagner school. Billings kicked off the first of a two events aimed at explaining the key problems embedded in the current US health care system.  In the second part of the series, Professor Paul Light will join Professor Billings and journalist Trudy Lieberman in a discussion of the proposed solutions being debated in Washington.

Professor Billings, an expert on safety net services and barriers to optimal health for vulnerable populations, had no shortage of data-heavy slides equipped with graphs and charts that clearly show that our health care system presents a problem we have ignored for far too long.  Billings spoke of several primary interrelated problems: un-insurance, cost, and health disparities.

But more than simply state current trends in these areas as obvious problems, Billings successfully defined why these are crises we must address.

“Insurance matters,” said Billings.  Approximately 45 million people in the US are uninsured and a whopping 39% percent of uninsured hospital admissions are avoidable, a burden we all bear, both morally as well as economically.  Billings argued that health care costs have soared, at a rate of nearly 9% a year, comprising less than 6% of the GDP in 1962 and nearly 16% in 2007.  Why does this matter? Why is this a problem? Because increased health care costs eat up government budgets, diverting money from other sectors of the economy like education and social services, while simultaneously suppressing wages.  And to make matters worse, increased costs have not been met with increased quality and better outcomes.  In fact, the US ranks 103rd in infant mortality rate.  

Billings said that health disparities, differences in treatments and outcomes based on race, ethnicity and sexual orientation, present the most challenging problem in our current system. Studies show that when controlling for age, gender, and income, blacks get fewer cardiac tests than their white counterparts, a dynamic that won’t be addressed simply by getting access to an insurance card.

Nothing in the health care reform being debated in Washington will attack this problem, Billings said.  But to find out more about the Congressional debate brewing in D.C., you will have to come to the next installment on October 26, 2009.

While Billings touched upon possible solutions like changing the way doctors are paid, creating smoother communication between health care delivery systems and instituting service checklists, Part II – on October 26, 2009 –will truly shed light on what our representatives are planning for the future of our health care system.

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