The Right Way to Reform Healthcare

Curing is cheaper than caring.

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[See photos of the Obamas behind the scenes.]

The elites in Washington and New York saw healthcare as an opportunity to save money. Not on themselves, of course, but for everyone else. But folks clung to the view that one goes to the doctor to get better and to feel better, not to wave around a government-issued insurance card. The real health problem, in the intuitive popular view, is that we don't have cures, or anything close, for killer diseases.

Enter Shriver and O'Connor. The first lady of California, in conjunction with the Alzheimer's Association, has launched a new national effort against Alzheimer's disease. She doesn't want simply to treat it, she wants to beat it. And in setting such an ambitious goal, she is invoking the memory of her famous uncle, John F. Kennedy, the greatest goal-setter in modern American history. Speaking to ABC News's Diane Sawyer last month, Shriver said, "We can launch an expedition on the brain, much like President Kennedy launched an expedition to the moon." Ah, for the days when the Establishment thought in terms of constructive and forward-looking projects that were also politically popular.

Then Sandra Day O'Connor joined in. The first woman appointed to the Supreme Court published an op-ed in the New York Times, joined by Stanley Prusiner, recipient of the 1997 Nobel Prize in Medicine, and Ken Dychtwald, a gerontologist, calling for a Kennedy-esque moon-shot-like effort against Alzheimer's. The trio emphasized the foolishness of our current spending priorities: "As things stand today, for each penny the National Institutes of Health spends on Alzheimer's research, we spend more than $3.50 on caring for people with the condition." Indeed, that care now costs us $172 billion a year and is rising fast, alongside the rise of Alzheimer's in our aging population. And yet, they added, medical science offers a way out of this fiscal thicket: "If we could simply postpone the onset of Alzheimer's disease by five years, a large share of nursing home beds in the United States would empty. And if we could eliminate it, as Jonas Salk wiped out polio with his vaccine, we would greatly expand the potential of all Americans to live long, healthy and productive lives—and save trillions of dollars doing it." Yes, we saved money on polio treatment by eliminating polio. And while our victory against another epidemic, AIDS, is far from complete, the progress we made has saved not only lives, but also, as the Manhattan Institute estimates, some $330 billion.

Longer lives, money saved. Talk about a win-win. Curing is cheaper than caring. And the 67 percent of Americans who believe they are being undertreated are ready to reward the leaders who orchestrate that win-win strategy.

We might note, here, a warning to Republicans. Just as the Democrats' expanding health insurance didn't "bend the curve" on costs, neither will shrinking health insurance achieve the desired curve-bending. If people get Alzheimer's, it's expensive, no matter who pays. And the real issue isn't health insurance, it's health. So long as the two parties see-saw on the issue of insurance, they will miss the real opportunity to save money—by providing health itself.

[Check out our editorial cartoons on the Democratic Party.]

The challenge is to get this new approach to healthcare—call it, simply, "medicine"—onto the national agenda. Getting it past the Establishmentarians who have invested deeply in the idea that when it comes to healthcare for the masses, less is more. Getting it past politicians who would rather fight each other than solve a problem for the nation as a whole.

That's where Shriver and O'Connor have proven themselves to be visionaries. They are changing the debate and, ultimately, they will win, because it's obvious that eliminating disease is a kinder, gentler, and smarter approach than simply paying for the ravages of disease. 

  • Check out our editorial cartoons on healthcare.
  • See which members of Congress get the most in campaign donations from health professionals.