problem will be with us for decades, like a bad cough we can't shake.">

Dave Helling | A very certain forecast for health care

Dave Helling

The Kansas City Star

The question I got most often during my days in television didn't involve politics, or specific stories, or even what my co-workers were really like.

Instead, it was this: "Why is the weather forecast always wrong?"

I always rushed to the defense of the weather folks. In the first place, they're actually right most of the time.

Unlike reporters, who usually write about the past, forecasters have to predict the future -- an extraordinary challenge. If my job depended on accurately forecasting the winner of any particular campaign, I'd have left this industry a long time ago.

So I won't predict what the Supreme Court will decide on health care reform. I won't even predict when they'll decide. Could be today. Could be tomorrow.

But I will hazard this guess: No matter what the court decides, and no matter how Congress and the White House respond, health care as a problem will be with us for decades, like a bad cough we can't shake.

Because the real problem isn't Obamacare, or the alternatives to it. The problem is what health care costs.

In April the Centers for Medicaid and Medicare Services issued its own forecast of what we'll spend on health care over the next decade. By 2021, it said, America will spend $4.78 trillion on medical care, insurance and other expenses, about 19.6 percent of the nation's entire economic output.

But the actuaries also guessed what we'll spend on health care if Obamacare goes away. The answer? $4.72 trillion -- a rounding-error difference.

So no matter what the court decides, if America can't figure out a way to reduce the cost of hospital stays and office visits and flu medicine, the share of the nation's fortune needed for health care seems certain to grow, taking away cash that might be used for schools, roads, homes and families.

Figuring out ways to limit health care costs is quantum-physics-level difficult. In general, Democrats say the government should intervene in the marketplace, limiting payment rates to doctors and hospitals, forcing insurers to be more efficient. Republicans say that would cut off access to care. Instead, they say, open competition will help reduce costs.

The spending projections suggest neither approach will work.

It's pretty clear that if America is to spend less on health care, someone will simply have to take less money -- doctors, hospitals, health care workers, insurance companies, bureaucrats, malpractice lawyers, drug companies. And patients who will have to pay more.

In fact, it's almost certain everyone involved in health care -- that is, everyone -- will have to give something up before health care costs can start coming down.

Call it a 100 percent chance of participation. That's a prediction even a non-weatherman can make.

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