There was a time when the most important legislation affecting the financial future of General Motors Corp. was probably the setting and adjusting of fossil fuel emissions standards or corporate tax overhauls. Today, GM CEO Rick Wagoner might argue justifiably that healthcare policy is trumping both of them. Wagoner, like many other executives at companies of all sizes across the U.S., is coming to the realization that the nation's relentless and disproportionately high healthcare inflation is fast becoming the single most competitive disadvantage some U.S. companies must shoulder. Recently, Wagoner testified before Congress seeking relief. Other executives should begin to follow suit. But they must insist on more than piecemeal tweaks of tax policy. Solutions to the healthcare problem have primarily been restricted to efforts to slow the growth of the cost spiral from an unacceptably high starting point. While many companies will disagree with Wagoner's suggestion for a reinsurance pool of those Americans with chronic health problems, the proposal at least begins to address the roots of the problem: We have a very small number of people using up a very high percentage of healthcare. We also have a system that is more sick care than healthcare since it ignores people until they are actually ill. Here, too, Wagoner seemed to be on the mark when he talked about the need for policy to begin to focus on keeping people well and fit. Although we have stumbled along for the past few decades applying a variety of miracle cures to the problem, the nation now faces a huge challenge from an aging population. This fact makes the entire strategy of cost shifting to the individual untenable over the long run. While there are no good answers right now, there never will be without active participation from Corporate America.

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