Friday, July 24, 2009

Ignoring the Rising Cost of Health Care

What I wrote last week - that the while the health care bills currently before Congress insure the uninsured, they don't do much to control health costs - has since become conventional wisdom. I (and everyone else) based what I said primarily on the Congressional testimony of CBO Director David Elmendorf and partially on my own meager understanding of the issue. There's a lot more to base it on now. In the seven days since that post, some of the folks echoing this argument include:
  • The Mayo Clinic, one of President Obama's favorite examples of health care done right, which says, "The proposals under discussion are not patient focused or results oriented... Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither."

  • David Brooks of the New York Times, who accuses lawmakers of claiming, "We’re going to eliminate the biggest, hairiest, most entrenched problem in the country without fundamentally changing the system and without asking for sacrifice from anybody."

  • Financial Times columnist Jacob Weisberg in the weekly Political Gabfest: "The three bills that are working their way through Congress, I think, look deeply, deeply flawed. They basically accomplish the one goal of covering the uninsured, but they are very weak... on cost control and I think they are very weak at what I would call the structural reform: Are you trying to change the system of fee-for-service medicene, which drives a lot of the inflation? Are you trying to do something about having an employer-based system which doesn't make sense anymore?"

In the interest of fairness and presenting both sides, I should say that New York Times columnist and Nobel laureate Paul Krugman is lauding Obama for focusing on controlling Medicare cost--to which I say, that may be true, but Obama has largely removed himself from this debate by not introducing his own bill. He has allowed the Democratic Congress to take the reins, and Congress is falling flat. If Obama wants praise for focusing his speeches on the right details, he should put that focus in a bill since it's become obvious that no one else will. I like the White House's new talking point that the cost of inaction is the highest cost of all, but while that's true, it isn't enough.

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