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Video: Economist: Country should be reimbursing for health

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    >>> now. the congressional budget office , mika stop --

    >> i want to meet them.

    >> the congressional budget office is out with their score of the president's health care law . mika 's going to tell you about it now.

    >> yeah. now that supreme court has made its ruling. joining us from washington --

    >> that's an incredible story, harold told us.

    >> i would like to meet those people.

    >> joining us from washington , economist and professor of medicine and public policy at the university of southern california , dana goldman , very good to have you on the show this morning. tell us what you found and how this ultimately turns out to be an investment for the american people .

    >> talk about the cbo report.

    >> i want to hear about the cbo report.

    >> don't go to the leading question yet. what did the cbo find out about this health care law ?

    >> the health care law as you know is remarkably expensive, even in the context of washington , d.c., and i think the fundamental question for us, is whether the country can afford it. when you think about that --

    >> how expensive? i'm sorry. just trying to get the facts out. what did the cbo tell us? how expensive is it?

    >> well, you know, i actually don't have the numbers in front of me, so i wouldn't want to speculate right now on the actual costs.

    >> so let's see. mika , do we have a full screen on this?

    >> i'm hoping. okay. so we're getting that right now.

    >> i'm sorry. go ahead, dana .

    >> i guess -- i think regardless of the cost, the real question is not what is the growth in health care spending. as you know, it's been going up and exceeding the growth of gdp for many, many years. and health care spending is now 20% of the economy. and we view it as an expense, but the fundamental point as you were talking earlier about education, for example, when we think about education, we think about it as an investment and it's an investment in building human capital so that we can go out and be productive members of society. and health care is the same way. health care spending are investments and the investments are in health and i think the point and where we have failed in reform is that we shouldn't be reimbursing for health care inputs, things like getting treated. we should be reimbursing for health and when you think about it that way, it leads to a lot of different policies than what we have now.

    >> all right. you recently said in "the new york times" this, if we reimbursed on the basis of preventing disease rather than treating it, the world would be different. with obesity, for example, you could imagine a much more concerted effort not only for diet and exercise, but also bio medicine a pill to prevent obesity would be worth literally trillions of dollars.

    >> mika ka, you're writing about this right now. you look at the cost of obesity.

    >> that's everything that pertains to our health care crisis, literally everything.

    >> obesity touches -- we always think about heart, but my gosh, you can't find a cancer where the risk doesn't increase if you're obese.

    >> diabetes.

    >> diabetes.

    >> everything.

    >> it is -- dana , i'm not sure a pill is really the solution because we have to look at our food system ultimately.

    >> but you're --

    >> we spend $93 billion for obesity-related preventative care and $96 billion for smoking-related.

    >> are those annual numbers, dana ?

    >> yes. in fact, actually the costs are much higher when you take into account the conditions that are a result of these behaviors. diabetes, heart disease , and the like. but i think the important point i was speaking with one endocrinologist who told me the best thing i could do for this patient is take them for a walk but i'm not paid to do that. and the point is, you know, actually why aren't we paid for that? i mean --

    >> yeah.

    >> no. it's a great question. mike, you look at diabetes, and you look at the extraordinary costs diabetes exacts on the system. sometimes you'll have insurers that won't pay for children preventati -- certain preventative care . but if you have to have your leg amputated they'll pay for that.

    >> that happens every single day of the week with insurance. everyone, dr. goldman , i think is aware of the bur goning cost of our health care system , but what is the cost or the potential cost or ever been factored into all these discussions, the cost of not having a health care system , a national health care system, at some point? i mean we're going to have 10, 20, 30, two or three more generations of people who the emergency room is their family doctor, things like that? what's the cost of not having a comprehensive health care system ?

    >> that's right. actually, as you think about going forward, when as we begin to discover more heroic life-saving measures, the cost of having a population that potentially is highly disabled,disabled, can't live in the community and requires nursing home care and other features, we actually see this right now with alzheimer's. one of the unfortunate consequences of doing so well in cardiovascular disease and cancer is now people can live long enough to experience severe cognitive impairment. this is becoming a social epidemic. you're right that the solution may not be biomedical. the solution -- my point is only that we need to reimburse in such a way that we encourage the right type of solution, the best one for society. it may be exercise and diet-related, for example.

    >> dr. goldman , thank you. uh i couldn't agree more with that. coming up, "the daily show " continues the push for a her herman cain presidency.


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