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Politics and Your Practice: Healthcare’s Biggest Headache


The biggest problem in healthcare? It’s not what you think.

Neither is it dealing with physician reimbursements, nor a dozen other “hot” topics.

No, the most important healthcare headache is reducing America’s dependence on foreign oil.

While we pursue a war against religious terrorists, our continuing reliance on foreign oil makes it less likely that seemingly intractable domestic problems - like those in healthcare - will be addressed. And as the war continues to absorb budget dollars and political capital, our reliance on foreign oil also restricts our foreign policy options, making the fight against terrorists all the more difficult.

So why doesn’t the president declare energy independence an urgent national priority, the way President Kennedy declared his determination to land an American on the moon by the end of the 1960s?

Right or wrong, since the days of Democratic sweater-wearer Jimmy Carter, energy conservation has been perceived as a sign of weakness rather than strength. My speculation: Energy conservation is not an issue our Republican, terrorism-fighting commander-in-chief wants to pursue.

The Bush administration is not ignoring the issue, but the former oil executive president does not come to this naturally.

In May, the president visited a Pennsylvania nuclear power generating station, urging a more diversified energy policy that makes the U.S. less dependent on foreign energy. The White House’s slow-moving plan calls for boosts in coal, nuclear, natural gas, and other renewable energy sources. The results are not yet promising.

The public, which is often wiser on Big Issues, is shortsighted here. In a recent CBS News/New York Times survey, most Americans said the top problems facing the U.S. are the war in Iraq, followed by the economy. Foreign oil dependency didn’t even make the top 10.

That’s too bad. A national commitment to energy independence, mandated by the federal government, would unleash an economic boom, as government priorities - tax laws, regulations, government contracts, expense policies - would change dramatically. Business and job growth would follow, providing new tax revenues and opportunities for domestic spending.

Some progress seems to be happening beyond Washington. More than 20 states are now directing utility companies to obtain as much as one-third of their electricity from “renewable sources” within the next 10 years.

Which brings us back to healthcare. By 2016, Medicare physician reimbursements are slated to be reduced by 22 percent. And at the current rate of growth, the number of uninsured will likely exceed 60 million by that time.

You might ask, isn’t our rising energy dependence just another excuse for politicians who fail to spend the time, energy, and political capital to solve problems? The challenges arising from reductions in physician reimbursements and the rising ranks of the uninsured have been around for many years.

That may be true.

But as the war against terror escalates and federal budgets get tighter, restructuring domestic problems will get tougher. If we could reduce our dependence on foreign oil, we would gain better footing in our battle against terrorism.

Until that happens, the costs of solving the biggest healthcare challenges in this country are likely to get window dressing.

This article originally appeared in the October 2006 issue of Physicians Practice.

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