Cost containment remains a component of every healthcare reform plan on the table. But, as the 1994 political season enters the crucial stage, it appears saving money no longer holds the attraction it did when the plans were hatched.
Why, for instance, would the board of Cook County, Ill., overwhelmingly vote to build a new 464-bed, $570.3 million public hospital when the Chicago area has thousands of hospital beds that are unfilled every day of the year?
It's hard to deny the current Cook County Hospital is decrepit. But there are other problems, such as a labor force bloated with patronage workers. Regardless of the quality and cost-effectiveness of care received at Cook County, the board's decision to spend so much public money begs the question of whether the government belongs in the business of providing healthcare.
If a rational system is to take root, public hospitals and Department of Veterans Affairs hospitals should face the greatest scrutiny.
Excess capacity, to some extent, has sparked the inflationary spiral because healthcare is one of the few industries that somehow circumvents the law of supply and demand.
Cook County could contract with local hospitals to treat the indigent patients who now use the public hospital. Money earmarked for new public facilities could be better spent subsidizing insurance for the poor and ensuring that providers are paid in a fair and timely fashion.
The success of healthcare reform requires sacrifice from payers, patients and providers. Cook County and other public entities should finance and oversee treatment for the poor. They need not provide the care. At a time when thousands of World War II and Korean War veterans are becoming frail and elderly, the VA should concentrate its efforts on long-term-care facilities instead of costly medical centers.
If the government can make those kinds of sensible sacrifices, there may be hope for healthcare reform.