Video: John Kitzhaber conference call on Election '08

The following comment was submitted by Stephen Gregg:

I am a documented critic of Kitzhaber's reform posture, but feel his intro was an excellent summation, which unfortunately transcends ultimately to rhetoric.  

While he refers to the question of the legitimacy of employer based insurance which the McCain proposal justly challenges, Kitz does not seem to definitively deal with the subject. He seems to criticize our health system for a lack of breath of mission, while recognizing that the broader issues stand outside of the sphere of the health care industry as we know it. As an example possessing a high school diploma or GED is a bright line differentiator.  This would seem to suggest we should be taxing or otherwise reallocating health care dollars to education.  The "elephant in the room" is not the uninsured but how after decades of failed policy efforts do we control health care costs, recognizing that finding more money through direct subsidy or tax credits is more than likely inflationary to those underlying costs. While hotly divisive as to who do we get to pay the health care tab, the essence is that absolutely nothing works if the costs are not brought under more satisfactory control.  

None of the candidates, nor Kitzhaber, in my estimation offer a credible strategy to control costs...thus reform devolves to debates about mandates, who pays etc.  Kitzhaber seems to imply the answer rests with "prevention" related strategies...but yet academics who study the role and impact of prevention on controlling costs advance with some vigor that there is "no evidence" that this belief system can be substantiated.  If we are into articulating "primary problems", one of them must be the failure of "experts" who promote and drive policy do not to understand the nature of health care cost containment.  Thus we just chase one unsubstantiated "hopeful policy" after another.

Modern day cost containment seems to have started in the 1960's and if you look at the Democratic platform of that period it postulates words to the effect that "the reason we have totally unacceptable health care costs, is that we have too few doctors and hospital beds" (supply - demand proposition), which became much of the economic rationale of Hill Burton hospital construction grants and doubling medical school enrollment to the unfortunate ultimate realization that the pathology of the community is relatively infinite. 

Economic trajectory of all this is unfortunately devastating.

Good luck in your efforts.

– Stephen Gregg