Now that we are in 2009 we need to find ways to pay for the health system we want.
How do we raise revenue or reduce costs? Here are seven areas to consider:
1. Increase the tax on tobacco and alcohol with proceeds going to health. (Disincentives for smoking, including citywide smoking bans, have been proven to work.)
2. Enforce clean air and clean water laws.
3. Make companies pay for health consequences of their actions.
4. Encourage widespread use of health information technology.
5. Use mobile phone/messaging systems to support consumers in managing their own health.
6. Reinvent the school nurse/clinic model.
7. Create luxury taxes with proceeds going to health.
Unfortunately, what we do now is either play a shell game with costs or reduce services and resources from the groups that squeak the least. Both of these are unacceptable. The reality is that since we want to provide more people with health care and we want better care for all, total costs will increase.
If we want more, then we will have to accept that our total costs will be more too.
