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Our Health Care System Is Organized for the Wealthy -- We Can Change That

We are accustomed to living in a sharply tiered society, but it doesn't have to be that way with health care.

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But in the 1980s and 1990s, we didn't ask those questions. Instead, as the authors of The Limits of Growth predicted, " investment in human resources (education, shelter, [public] health care) were postponed in order to provide immediate consumption and security demands.”

By the spring of 2004, I was worried as I completed the final chapters of Bull! A History of the Boom and Bust, 1982-2004 :  " U.S. real estate sits on a mountain of mortgage debt. If Washington's goal was to create a faith-based economy, it is succeeding." 

By 2005 the share of income held by the top 1 percent was as large as it had been in 1928, when the last Gilded Age drew to a close. This was an ominous sign.  

By 2006, "household debt equaled 90 percent of GDP, up from a low of 12 percent at the beginning of WWII," Van Doren observes . "U.S. credit card  debt currently exceeds $950-billion  . . .  For two decades consumer spending had been the engine that drove the U.S. economy but now, Van Doren points out, "the American consumer is ‘tapped out.'"  

In the second part of this post, I will explain what all of this has to do with healthcare reform. Americans are not all in the same boat, and this could threaten fair-minded reform. The divide is partially based on ideology, but it also reflects greater economic security among some voters. At the same time, the lobbyists already have begun to fight any effort to measure value in our health care system. Nevertheless, if the voters who elected President Obama unite, we can win high quality, sustainable healthcare for all.

Maggie Mahar is a fellow at the Century Foundation and the author of Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006). This originally appeared on The Health Beat .

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