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Facing Up to Hard Facts About Health Care Cost and Access

MANAGED CARE August 2002. © MediMedia USA
Editor's Memo

Facing Up to Hard Facts About Health Care Cost and Access

John A. Marcille
MANAGED CARE August 2002. ©MediMedia USA

John A. Marcille

Thomas Jefferson said, "Were it left to me to decide whether we should have a government without newspapers, or newspapers without a government, I should not hesitate a moment to prefer the latter." Of course, Jefferson was not in power when he wrote this in a letter to Edward Carrington in 1787.

It's been a feature of our democracy that we usually have to wait until a politician is out of office before hearing anything interesting from him. This is not to say that Richard D. Lamm, the former governor of Colorado and the subject of our Q&A feature, didn't say interesting things in the 12 years he ran his state.

However, what he has to say now about our obligation to future generations, in terms of the entitlement mentality that threatens to choke Medicare and Social Security, are not calculated to win popularity contests. Catch this exchange:

MC: In 2010 or 2011, I can see the over-65 cohort responding to any crisis in Social Security not with broad solutions but simply by demanding the same benefits their parents had.

LAMM [who is 66]: Who can blame them? I guess I can blame them. This is the challenge. Every society has a challenge to meet the realities that it's faced with. My parents faced a reality called the Depression, then faced realities called Hitler and Tojo.

Tough decisions, and the question of evading or tackling is also an underlying theme of Senior Editor Frank Diamond's cover story about the educated consumer. The tough decision needed: How are we going to pay for health care?

Better education of consumers has been put forward as either an answer or an evasion. If it's merely an afterthought or an alibi for the cost-shifting that most agree is inevitable, then it's evasive.

If it's truly a solution, then all the potential, as well as problems, associated with the educated-consumer concept must be tackled in a responsible way. Are we up to the challenge?