Commentary: Some guarantees needed in health care debate

This editorial appeared in The Miami Herald.

If promises were dollars, the pledge by the health care industry to reduce costs by $2 trillion over 10 years would be a cause for celebration. Unfortunately, these promises are only words, not guarantees. If we have learned anything at all from decades of failed attempts to reform the way Americans get medical care, it's that promises, good intentions and voluntary guidelines don't work.

The industry coalition – doctors, pharmaceutical companies, HMOs, other providers – says it can shave 1.5 percent off the projected annual rate of growth of 6.2 percent per year over the next decade by voluntary methods. This represents a significant savings. Without it, the difficult task of financing coverage for the estimated 45 million Americans without insurance would be nearly impossible.

However, such pledges have been made before, such as when former President Bill Clinton tried to reform the system in the 1990s, but the result was short-lived and ultimately unsuccessful.

Managed care, market competition, regulation, voluntary restraint – call it what you will. Nothing has had a lasting impact on the steeply rising cost of medical care. Nor have these efforts yielded wider or better coverage. This is why an overhaul is needed.

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