Modest, far-reaching cost control
Ezra Klein
WashPost
Harvard economist (and former Obama campaign adviser) David Cutler runs through the 10 most promising cost control ideas of the past few decades and notes that six of them are fully included in the bill, three of them are at least partially present, and only one of them -- the public option -- is totally absent. "No one knows precisely how much medical spending increases will moderate," Cutler concludes. "But one cannot doubt the commitment to try. What is on the table is the most significant action on medical spending ever proposed in the United States."
One addendum to Cutler's op-ed: Cutting health-care costs is hard. And it needs to be distinguished from simply capping spending. When liberals say that single-payer will save a bazillion dollars, or conservatives point to Paul Ryan's plan and say that will save a bazillion dollars, they're talking about capping spending. Liberals do it on the provider side, saying that government will only pay so much for medical services people need, and the system will just have to adjust. Conservatives do it on the consumer side, saying that government will only give individuals so much for the coverage they need, and if that proves insufficient, then tough. But voters haven't evinced much appetite for either proposal.
So smart people have spent the past few decades trying to figure out softer ways to cut costs without cutting things that people need. One popular idea is to change payment systems so that they don't reward doctors for volume. That's in the bill. Another is to build more competitive insurance markets so that insurers have a more direct incentive to keep costs down in comparison to one another. That's in the bill. Another is to try to bring individuals closer to the true cost of the insurance coverage, which is currently hidden by employers. That's in the bill. And so on.
(Original here.)
WashPost
Harvard economist (and former Obama campaign adviser) David Cutler runs through the 10 most promising cost control ideas of the past few decades and notes that six of them are fully included in the bill, three of them are at least partially present, and only one of them -- the public option -- is totally absent. "No one knows precisely how much medical spending increases will moderate," Cutler concludes. "But one cannot doubt the commitment to try. What is on the table is the most significant action on medical spending ever proposed in the United States."
One addendum to Cutler's op-ed: Cutting health-care costs is hard. And it needs to be distinguished from simply capping spending. When liberals say that single-payer will save a bazillion dollars, or conservatives point to Paul Ryan's plan and say that will save a bazillion dollars, they're talking about capping spending. Liberals do it on the provider side, saying that government will only pay so much for medical services people need, and the system will just have to adjust. Conservatives do it on the consumer side, saying that government will only give individuals so much for the coverage they need, and if that proves insufficient, then tough. But voters haven't evinced much appetite for either proposal.
So smart people have spent the past few decades trying to figure out softer ways to cut costs without cutting things that people need. One popular idea is to change payment systems so that they don't reward doctors for volume. That's in the bill. Another is to build more competitive insurance markets so that insurers have a more direct incentive to keep costs down in comparison to one another. That's in the bill. Another is to try to bring individuals closer to the true cost of the insurance coverage, which is currently hidden by employers. That's in the bill. And so on.
(Original here.)
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1 Comments:
When I clicked through to read the piece, Klein’s previous column deserves a quick read … turns out Paul Ryan’s Roadmap for America’s Future which got some media attention for its Medicare proposal, will not balance the budget as projected … but the plan would give a huge tax cut to the wealthy, while cutting taxes by little or nothing (and in some cases even raising taxes) for low- and middle-income people.
Isn’t that how we got into this mess ?
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