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Throughout the health care reform debate much has been made of the USA expending approximately 16% of our gross domestic product (GDP) on health care and how this is a significantly greater percentage compared to other countries.

The fact is that a nation’s expenditure for health care can be viewed as a purchase or as an investment. In most countries around the world GDP health expenditure is for purchase of medical services and products like surgical or diagnostic procedures, drugs and medical devices. In stark contrast, the United States has directed its health expenditure not only for purchase of medical care, but also as an investment in research and development of state of the art medical care. Therefore, it should come as no surprise that most of the progress in biomedical research and medical breakthroughs have occurred within the United States.

This investment has been a blessing not only for Americans but for people around the world in need of state-of the-art care for cancer or a transplant or any one of a host of miraculous-like interventions. The problem is that when one combines the cost of purchase and the cost of investment the price tag is increasingly more expensive.

Congress and the Administration must address the future of health care for Americans with careful consideration of both the price of purchase and the cost of investment. The price of purchase can be reduced without sacrifice of quality by a rational and effective approach to eliminating cost drivers. The cost of investment, however, can only be considered in the context of the return on investment.

The investments we have made are already paying dramatic dividends in lives saved and the best is yet to come. For people threatened by Alzheimer’s, dementia ,diabetes, AIDS, metastatic cancer, pandemic influenza, paralysis and a host of other acute and chronic diseases, health reform must assure them that this nation’s investment in biomedical research and development will continue.

Show your support for research and development on the CHT poll (www.healthtransformation.net).

Why can't we start with the government programs like Medicare and Medicaid reimbursing providers at a rate that is true to the cost of the service? This will bring down the price of services for customers in the private market that are currently subsidizing government customers through higher prices. This will increase the programs' budgets, but the private market could get back to reasonable rates and have relief. Once we have a true cost of the government programs, then we can cut and/or adjust those.

If you want healthcare for all then have all doctors, hospitals and heathcare facilities donate two days a week to those who don't have health insurance and give tax incentives.

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