Columnist Jim Fossel is partly correct when he suggests that health care cost control is possible (“Free the health care market,” July 23). Effective efforts exist right here in Maine. The Maine Health Care Coalition is a good example.

The principal issue is not cost, but rather the growing portion of our population that falls in the chronic care group. I am amazed that this “elephant in the living room” is not even mentioned. It is the largest cost center in our health care expenditures.

Reducing the chronic care population is important for more that cost reduction. The demographics of this group make clear that most people in this group have a childhood history that is preventable. Failure to do so has costs way beyond health care costs. We are throwing away critically needed human resources.

Unfortunately, prevention is not simple or short term. Politicians will need to develop the courage necessary make unpopular decisions. While it may be politically easier to blame the poor and cut health care and other supports, it does not solve the problem.

Critical steps are necessary beginning with making better use of the resources we have now. For 40 years one task force or another has recommended simplifying Maine children’s services system. Politics has always prevented action. A unified structure can reduce administrative costs and increase federal support. Having a system that is understandable could be a side benefit.

Prioritizing expenditures toward early childhood has been advocated for an equally long time. Instead we have reduced early childhood expenditures. Research shows that the greatest bang for the buck comes from money spent on very young children. Yet our education expenditures are greatest for the high school years. We are the only industrialized nation that does this.

It’s way beyond time to make some changes.

Dean Crocker

Manchester and Estero, Florida

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