Published: Sunday, September 13, 2009
HEALTH-CARE REFORM
Get more specific on costs
Seeking to reframe the health-care debate in a powerful speech to Congress Wednesday, President Obama made a discernible move toward the center — a wise one if he wants to see a meaningful reform bill by year’s end.
But the challenge in appealing to moderate and independent Americans is that they tend to be deficit hawks. Knowing this, Obama vowed that his 10-year, $900 billion plan wouldn’t add to the federal debt, now or in the future.
Deficit hawks are a skeptical breed, however. Against the backdrop of record red ink — the budget shortfall sits at $1.38 trillion with one month to go in the fiscal year — Obama must do much more to spell out how he’ll expand coverage to millions more Americans without increasing overall government spending.
The main solution he pitched Wednesday, eliminating hundreds of billions of dollars in fraud and waste, is a lot of bone and little flesh. Skeptics are right to question just how such savings will be achieved.
Further cutting federal reimbursements to providers who are already losing money on Medicare and Medicaid patients is no answer. In our state, where providers already receive less in federal reimbursements than many other states, more cuts could mean fewer doctors willing to see Medicare and Medicaid patients.
Transforming the health-care system’s current fee-for-service model that rewards the number of tests and procedures into one that rewards cost-effective patient outcomes is a good answer, but it’s unclear how quickly it can be implemented or how much money can be saved.
Until Obama gets a lot more specific, his promise of budget-neutral reform looks like wishful thinking. That’s not going to win over many independent voters — or, we suspect, conservative Democrats in Congress, without whose support no reform bill can succeed.
The president is on the right track in many respects. His plan for an independent commission of doctors and medical experts to identify waste and expand reforms that save money and improve patient outcomes is essential to getting costs under control. His proposal to tax the richest insurance plans makes sense. And he’s right on target when he notes that bending the health-care cost curve downward is pivotal to the nation’s fiscal future.
But his vow to not let reform increase the deficit, now or in the future, must be more than a vague promise. As such, it’s not believable. If meaningful reform is to pass this year, the president needs to get specific about how he’ll pay for it.
But the challenge in appealing to moderate and independent Americans is that they tend to be deficit hawks. Knowing this, Obama vowed that his 10-year, $900 billion plan wouldn’t add to the federal debt, now or in the future.
Deficit hawks are a skeptical breed, however. Against the backdrop of record red ink — the budget shortfall sits at $1.38 trillion with one month to go in the fiscal year — Obama must do much more to spell out how he’ll expand coverage to millions more Americans without increasing overall government spending.
The main solution he pitched Wednesday, eliminating hundreds of billions of dollars in fraud and waste, is a lot of bone and little flesh. Skeptics are right to question just how such savings will be achieved.
Further cutting federal reimbursements to providers who are already losing money on Medicare and Medicaid patients is no answer. In our state, where providers already receive less in federal reimbursements than many other states, more cuts could mean fewer doctors willing to see Medicare and Medicaid patients.
Transforming the health-care system’s current fee-for-service model that rewards the number of tests and procedures into one that rewards cost-effective patient outcomes is a good answer, but it’s unclear how quickly it can be implemented or how much money can be saved.
Until Obama gets a lot more specific, his promise of budget-neutral reform looks like wishful thinking. That’s not going to win over many independent voters — or, we suspect, conservative Democrats in Congress, without whose support no reform bill can succeed.
The president is on the right track in many respects. His plan for an independent commission of doctors and medical experts to identify waste and expand reforms that save money and improve patient outcomes is essential to getting costs under control. His proposal to tax the richest insurance plans makes sense. And he’s right on target when he notes that bending the health-care cost curve downward is pivotal to the nation’s fiscal future.
But his vow to not let reform increase the deficit, now or in the future, must be more than a vague promise. As such, it’s not believable. If meaningful reform is to pass this year, the president needs to get specific about how he’ll pay for it.
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