Curbing Runaway Health Inflation - Times Editorial - Warning: substance!

[Mass]

Times has an editorial concerning the need to reduce health care costs. I guess most everybody will agree with the need, though there should be discussion on how to achieve this. The RW is of opinion that giving healthcare to everybody will increase the cost because people will consume it irresponsible -- of course, I take 2 blood tests and 3 MRIs just for fun, with some chocolate sauce on top--. which is, btw, why I am not that sure I agree on taxing companies that offer plans that are expensive (and most likely offer a good coverage). Have some courage, tax the rich to help the poor on their income, not the fact they have plans that we would all like to have.

This is why it is so interesting to see the NYTimes write an editorial with some substance in it, trying to understand the problem. Of course, we will all find something we disagree with in this editorial, but just talking about it, rather than about who's up and down in the Senate, is a progress.

Read the complete editorial, please, not the cut and paste that I have had to do.

http://www.nytimes.com/2009/08/02/opinion/02sun1.html?partner=rss&emc=rss

This year’s effort to reform health care revolves around two powerful, conflicting imperatives. One is to cover tens of millions of uninsured Americans. The other is to absorb the enormous cost of that plan — which could reach $1 trillion over 10 years — without increasing the budget deficit in the next decade or setting the nation on a course that will drive up deficits later.

It is easier to see how to accomplish the first task than the second. ...

It is much harder to find ways to slow inflation in health care costs. Peter Orszag, Mr. Obama’s budget director, has been searching for what he calls “game changers” that can “bend down the cost curve” in coming years. The question is how well he and Congressional champions of health care reform have succeeded.
...

HOW CAN WE JUDGE SUCCESS?
...

Respected analysts who are not bound by the C.B.O.’s conservatism have projected significant savings from reforms that the C.B.O. scores poorly. The Commonwealth Fund, a research organization, and David Cutler, a Harvard health economist, separately estimate that an array of reforms could save the government hundreds of billions of dollars in the first decade and the health care system even more. These estimates, coming from advocates of reform, may be too rosy, but underscore the point that the C.B.O. may undervalue savings.

POTENTIAL GAME CHANGERS It seems hard to believe that over the long haul the introduction of electronic medical records will not save substantial money. It would help eliminate the costly repetition of tests, and prevent medication errors that harm patients and lead to costly hospitalization.

...

TAXES One way to keep deficits in check would be to impose taxes within the health care system instead of more broadly, which should ensure that revenues increase at the rate of health care inflation. A tax on the value of an employer’s contribution to insurance could lead beneficiaries to choose cheaper policies and think twice before undergoing costly tests. We have been leery of recommending a tax that would affect many workers, but a tax on very expensive plans might make sense.

OTHER IDEAS The administration seems to have scoured the health policy literature for ideas, and its proposals reflect the thinking of the nation’s leading experts. Most of these ideas would first be tried on a small scale in Medicare — to see if they reduced costs while improving or at least maintaining the quality of care — before being adopted on a wide scale in government programs. Ideas that work for Medicare would presumably migrate out to the private sector.

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[NYC_SKP]

1. Nice find. Last Part: "Wrong Headed Criticism"

WRONG-HEADED CRITICISM
The Republican Party has started a campaign charging that President Obama is conducting a dangerous and reckless experiment in health care reform that will damage the economy, kill jobs, drive up health care costs, and harm patients. That is a bit hard to take after the Bush administration’s reckless squandering of government surpluses with tax cuts for wealthy Americans that cost $1.7 trillion over 10 years and an expensive Medicare drug benefit that is projected to cost almost $1 trillion over the next 10 years, without making provisions to cover their costs.

The Obama administration is paying meticulous attention to the need for offsets and new revenues. Most important, it seems headed in the right direction to finally slow the rate of growth in health care spending — a beast that has defied past efforts to tame it.

:patriot:

Recommended

[ProSense]

2. Good stuff. n/t

[WeCanWorkItOut]

3. Some good stuff; but it seems to favor "Medical Homes" --which could do a lot of harm

For example, the Commonwealth Fund is described as one of the "respected analysts," and yet they tend to promote Medical Homes. The "independent commission beholden to no one" is, I believe, a reference to MedPAC, which consists of some of the same people as in the Commonwealth Fund.

David Cutler, the other "respected analyst," has all sorts of credentials. But is he a meticulous thinker or just an advocate? Historically, he has tended towards advocacy, promoting big spending on health care.

The editorial wants to get away from fee for service, but that too may translate into a push for Medical Homes.

The problem is that Medical Homes can function like the HMOs, by whom many people feel short-changed.

Finally, to say that Bush botched his efforts, with which I fully agree, is maybe not the best reason to tolerate bad work on the current plan. I am really disturbed by the stories of all the lobbyists involved in this effort, and all the concessions being made to keep them happy. This could work out very badly indeed, with all the savings coming from the denial of needed care, rather than from the excess profits of the various providers.

That said, I agree, this editorial has some substance. I just hope people don't feel obliged to hurry too much. There's still a lot of substance that needs to get out there.