Better health care
is within our grasp
Health care in the United States is the most expensive in the world. But that’s because it’s also the best. Right?
Not exactly.
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According to Karen Davis, president of The Commonwealth Fund, not only are U.S. costs too high, but outcomes are not good enough.
The Commonwealth Fund, which focuses on improving the health care system through research and grant making, has found that “we have a very expensive, fragmented, disconnected system,” with high mortality and medical error rates, as well as too many tests.
One glaring area of waste is excessive administrative costs – 7.3 percent in the United States compared with 5.6 percent in Germany, 2.6 percent in Canada, and 1.9 percent in France. Davis said that if by getting down to the 2-percent range, we would save $85 billion – enough to cover the 46 million uninsured.
Ultimately, a real solution must be national in scope, but for the time being, states should be trying out new ideas. That approach sounds much like what the R.I. Economic Development Corporation has been accomplishing with its Innovation@Scale initiative.
There are hopeful signs, including the WellCare insurance program for small business and individuals. The concept, still in its infancy, is intriguing because it addresses four key cost drivers – primary care, the chronically ill, least-cost delivery and evidence-based care. But it is not designed to plug the gaps in the system.
Gov. Donald L. Carcieri should be embracing a larger vision that can serve as a model for the rest of the nation to evaluate. As EDC Director Saul Kaplan has said many times, Rhode Island should be taking advantage of its size to create best practices.
State ethics demand
greater scrutiny
I guess we should be grateful for any crumb of ethics reform. So the proposals the R.I. Ethics Commission will put up for a hearing next year are indeed a step in the right direction. Public officials shouldn’t supervise their relatives. And they should not move directly from public service to a lobbying firm. Nor should high-ranking political officers seek or gain employment in the municipality they serve.
But more is needed to wipe the stain of corruption from Rhode Island’s reputation and to make sure it doesn’t happen again. Here’s a for instance: The commission, which will be holding the hearings on the proposed changes, also voted to proceed with its investigation of Senate President Joseph A. Montalbano. If he is found to have violated ethics laws, the commission could fine him up to $25,000 per offense.
Monetary penalties are all well and good, but public officials who have ethical lapses should be removed from office. Only then can the state say that it is serious about its commitment to ethical government.
