Seemingly everytime we pick up a newspaper or periodical we see that health care costs have risen again.  The only real question anymore is 'How Much?'.  Of course, if we still have health insurance, the premium rates continue to go up and up.  What in the world can we do about this?  Would statewide mandatory insurance coverage do the trick?  Can we somehow legislate lower insurance premiums?  Are the drug companies really the culprits?  Maybe we simply need to move to Canada or Europe.

Recent studies show that our national health care spending increased in 2006 by 6.7% to $2.1 trillion.  That means that one out of every six dollars spent in our national economy goes for health care.  The 'good news' in this staggering number is that this is actually slower growth than we saw for 2005.  Apparently we're going in the right direction, even if too slowly.

Another amazing fact, to me at least, is the amount of 'out-of-pocket' spending each of us averages after insurance premiums, etc.  In 2006, we spent, on average, 12% out-of-pocket for our health care expenses.  Know what we spent out-of-pocket in 1960?  We spent 47% out-of-pocket for health care expenses. 

That means that we are shielded to a much greater degree today from our real health care costs than we were in 1960.  Our out-of-pocket costs have decreased steadily since 1960.  We are often at the point today where we think of the cost of health care as being the $10 or $20 co-pay we have to come up with when we go to see the doctor.  Or, the $20 or $30 dollars we have to cough up for medicines.  Those amounts are very small percentages of the total costs.

Why is this important?  It is important because we need to think about what we're spending if we're ever going to be able to bring this cost spiral under control.  If we come to understand that the real cost of the doctor visit is in the range of $125 to $150 or more, we can begin to understand that maybe we shouldn't be running to the doctor everytime we have a runny nose or a cough.

Another very interesting fact is this:  more than 50% of all health care claims costs in America today are to cover lifestyle-related illnesses.  Those are the things that you and I can control to one degree or another.  But, we can't control them if we don't know about it or if we choose not to do anything about it.  What are 'lifestyle' issues?  Smoking, alcohol use, obesity and simply laying around doing no exercise.

Does this apply to us?  Here are the most current facts:  One in every four Americans eat fast food every day!  Six of ten Americans do not exercise or seldom exercise!  Two of every three Americans are classified as either overweight or obese!

This is the real source of our health care cost crisis.  We have met the enemy and it is us!

No mandatory state programs, or profit controls on drug companies or anything else is going to solve this problem.  The simple truth is that this is up to us.  All the rest of these proposals are simply pablum calculated to make us feel good.

That is why this 'stuff' is flowing from the mouths of politicans.  And it does nothing to solve the problem!

Let your politicians know that you understand this.  If they really want to help us, they'll begin an educational program using some of the 'smoker money' to get the true message out.  And, be sure to tell them we do not want laws banning fast food or drinking or smoking.  We need to take responsibility for ourselves.  No one else can do that for us.  The marketplace will make its own corrections just as you've begun to see with the menu changes going on in the world of fast foods, for example.

Maybe if insurance companies were permitted to charge people what we deserve to be charged based on our lifestyle habits, we'd begin to see these changes occur.  If I smoke, I pay more.  If I'm overweight, I pay a surcharge.  Make me feel my wallet lightening up if I don't take personal responsibility (just don't think this is your new way to raise taxes). 

Don't just continue to blame big health, or big drugs or big insurance!  You are doing nothing but pandering when you resort to this, and we're on to you!

Maybe bold is a bit overdramatic; these things are almost certainly going to occur during the next twelve months...and probably during the next twelve months after that.

HEALTHCARE COSTS CONTINUE TO RISE...Of course that will happen as it has been happening for a long, long time now. 

We'll know what our healthcare delivery landscape will look like as we move through 2008.  We will be in the process of building too many facilities and that will ultimately drive costs up at an even greater pace.  We'll see the consolidation wave cresting and then we'll effectively have a couple of behemoths.  And that will ultimately drive health care costs up at an even greater pace.  We'll have continuing debate over the governmental control of our healthcare; and that holds within it forebodings for us all if we take the seemingly 'easy' pathway to universal coverage.  Government will continue to blame health insurance companies while it meddles in the free marketplace to the detriment of us all.  Will we be able to work our way through this coming year in healthcare?

TAXES WILL CONTINUE INCREASING...Again, of course this will happen as surely as the sun rises in the morning.

Our governmental bodies from village to state to federal continue to spend at a pace that simply cannot be sustained without damaging the economy.  Programs once instituted never die.  If funding channels go away (read cigarette taxes), the programs are simply shifted to using 'general purpose funds'.  And, as if the idea of never killing off useless tax-funded programs isn't bad enough by itself, our various government bodies add new tax-funded programs willy-nilly.  Our state budget just approved carries with it unfunded future obligations of something in the range of a billion dollars for the next biennium.  Our federal budget carries within it the same type of mischief.  Our politicos are absolutely addicted to 'earmarks' and those infect state budgets as well as federal budgets.

EDUCATION WILL CONTINUE TO BE DEBATED...And this, too, is a virtual given.

The primary state teacher's union, WEAC, has still not extracted its payback for the massive support provided to the Governor and many elected representatives.  Look for the QEO provision to be attacked and possibly thrown out if Democrats gain control of the Assembly in addition to the Senate and Governor's mansion.  Milwaukee's system will continue to move in precisely the wrong direction so far as numbers of graduates, test scores and almost every other measurable area.  Germantown's petition to move from MATC to another technical college district will be heard by the state technical college board, and only a miracle will see that petition granted.  We will have been accorded our 'due process' but come to realize that appointed boards do not provide 'due process'.  Virtual schooling will continue to be assailed by the teachers' unions...even though union member teachers are employed in those programs.  Why you ask?  Competition seems to be a great idea in everything but education, where the establishment simply cannot tolerate the possibility that we'll come to realize the king has no clothes.  There will be more referenda, and those that are properly presented will be voted on their merits from the electorates' perspective.  'Properly presented' means that the referenda are scheduled during an existing election, and not on some obscure date calculated to bring out only the 'right' voters.  'Properly presented' means that teachers and administrators are not employing taxpayer money to make their case, and that all the facts are presented well in advance to permit reasoned public debate.

ELECTIONS WILL DETERMINE THE WILL OF THE PEOPLE...And that is truly the hallmark of our country.

Our state government will be re-shaped and a Democrat sweep, should that occur, will virtually assure the we'll have universal health care called 'Healthy Wisconsin Two', higher taxes across the board, and fewer freedoms as government sucks up more of the available air.  We'll have more tax and spend programs that will take on lives of their own, and conservatives will trudge through the political wilderness for another decade or two.  Our Governor, who promised this would be his last term, has apparently decided that we need him for another term of four years.  Of course we expected that since other promises like 'no tax increases' have been conveniently forgotten, as well.

The federal scene holds a similar scenario.  People will need to evolve beyond the still-controversial 'hanging chad' feelings.  There was no Supreme Court fiat involved in the Florida race; that was a contrived attempt by the loser to fan the flames and get into office because he 'deserved it'.  So, he then went on to exploit the 'global warming' thing instead, while emitting more pollution that a thousand or more normal folks.  We'll have a new President-Elect by year-end.  The Iraq war seems to be less and less an issue as the press finally tells a more positive story...that has been going on for much longer than has been told.  The attempt to convince people that we're in a recession seems to be failing, but Congress still tries to make that happen with tax legislation.  For the first time since 1952, we have a wide-open race on both sides of the aisle.  What will happen if a strong third party candidate 'suddenly' emerges...like the 'sudden' emergence of Mayor Bloomberg of New York (as has been rumored for months now)?  That will throw everything into the proverbial 'cocked hat' on both the Democrat and Republican sides.  Yet another reason why congressional seats are so important.

2008 promises to be a very exciting and rewarding year, just as all the other years I remember have held great promise coupled with the aura of excitement...if we can but sieze those opportunities.

May you and yours enjoy a most healthy, happy and prosperous 2008...no matter your politics!