Inconvenient Truths on Health Care Reform

There's an elephant in the health care debate room.

Make that two elephants.

Come with me in the way-back machine to the year 1900, when ladies wore ankle-length dresses and men rode horses into town. Let's say we're on Main Street somewhere. A neighbor asks a farmer about his mother, and he replies, "She took sick and died. She was 50 years old."

There you have it. Those are the two elephants in the room for debates on Medicare, Social Security and health care reform. Mother took sick (and probably died at home). Average life span of an American in 1900 was 49.2 years.

A timeline of health care history goes back to the turn of the 20th century and summarizes all 10 decades up to the year 2000. According to the timeline, we've been in a "health care crisis" since the 1970s.

But let's go back to 1900 again.

In the little hospital on the prairie, there were no CT scans or MRIs. Doctors preferred cash, but they also accepted payments in goods and services. Catholic, Protestant and Jewish hospitals were founded in part to serve the poor.

Now let's move up to 1935. Social Security was passed into law to help senior citizens, half of whom lived in poverty. The average life span for men was about 59.6 years. For women, about 63.4 years. Retirement benefits began at age 65.

As for the ratio of workers to retirees, in 1945 there were 41.9 covered workers for every Social Security beneficiary. In 2006 the ratio had dropped to just 3.3 for every retiree. It's a wonder checks aren't bouncing as I write this.

Although health insurance dates back to 1847, it wasn't commonplace until the 1940s, when wage and price controls during World War II caused employers to offer insurance benefits to attract workers.

I'll bet today's business owners wish their wartime predecessors had thought of something else. As do their employees. Read Wendy Button's tale of woe: "Health Care Speechwriter for Edwards, Obama & Clinton Without Insurance Now."

Don't get me wrong. Our ability to increase life spans by over 50 percent is a phenomenal achievement. I'm an eight-year survivor of ovarian cancer. Without the medical advances of the last century, I too would have "took sick" and died like the women in 1900.

But facts are facts. What sealed our health-care doom was the failure of government to annually crunch the numbers and make changes every year, matching revenues to costs. Medicare was signed into law in 1965. In the 1970s, medical bills began to skyrocket.

In 1950 health care was 4.5 percent of the gross domestic product. By 2000 the percentage had risen to 14. You could argue that our health is worth 14 percent of GDP. Maybe so. But we still have to pay for it.

In 2003 a drug benefit added billions to the Medicare tab right at the time when the aging of the baby-boom generation would have suggested cuts, not expansion. Unfortunately, cuts in a program as popular as Medicare is political suicide. We "kicked the can down the road," as Sen. Jim DeMint put it.

Two months ago a Medicare trustee report stated that Medicare will go bankrupt in 2017.

There is no easy fix. But easy or not, we'd better find one, and soon. We're running out of time.