Quote-of-the-day mailing list
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Subject: qotd: The Democrats' market-friendly health care alternative
Date: Tue, 25 Sep 2012 10:44:45 -0700
From: Don McCanne <email@example.com>
To: Quote-of-the-Day <firstname.lastname@example.org>
The Wall Street Journal
September 24, 2012
The Democrats' Market-Friendly Health-Care Alternative
By Ezekiel J. Emanuel, Neera Tanden and Donald Berwick
Conservative and liberal health-policy experts agree that the key to
sustainable cost control lies in encouraging physicians and hospitals to
focus on quality rather than quantity, and value rather than volume.
According to a study published in August in the New England Journal of
Medicine, over the past decade per-person costs in Medicare have
increased less than those of private insurance, and are projected to be
1.2 percentage points lower than those of private insurance per year
over the next decade.
Why should anyone believe that the Affordable Care Act and our new
proposals will actually control costs? After all, skeptics argue,
Medicare costs have increased inexorably despite myriad policies
designed to control them. But we propose a break from the past, which
has largely relied on the government's setting of payments. Our
alternative is to allow the market to set many prices for medical goods
and then to change payment and reimbursement methods so that physicians
and hospitals have the incentive to keep patients healthy. This is
neither government nor insurer rationing. It is a market-friendly
approach that empowers health providers to re-engineer how they care for
Health Care Cost Institute (HCCI)
Health Care Cost and Utilization Report: 2011
For 2011, HCCI found increases in prices were the primary cause of
increased health care spending for the privately insured younger than 65
and covered by ESI (employer-sponsored insurance).
The rate of price growth for all major services outpaced changes in
utilization. The primary cause of increased prices was growth in unit
Comment: The authors of this Wall Street Journal opinion article have
participated in the development and implementation of the Democrats'
Affordable Care Act. Increases in prices continue to be a primary cause
of increases in health care spending, so what do these authors
recommend? "Our alternative is to allow the market to set many prices
for medical goods and then to change payment and reimbursement methods
so that physicians and hospitals have the incentive to keep patients
Health care prices remain a problem. The health care market, such as it
is, always has set prices high and will continue to do so. Utilization
is not excessive. It is comparable to other nations with far lower total
spending. Incentives designed to reduce utilization risk impairing
access to appropriate care, thereby impairing quality.
It is futile to continue to pretend that market approaches within our
highly dysfunctional financing system - that perpetuated by the
Affordable Care Act - will ever bring us quality health care at a
reasonable cost. Allowing the market to set prices is utter nonsense.
Our own public stewards, working with the health care delivery system,
can price our health care services and products properly, providing that
they are allowed to function as a single payer monopsony (not to mention
all of the other benefits of single payer financing).
We don't need more market-friendly Democrats. We need patient-friendly
politicians, though they are a rare sighting these days.