It Is Not the Curve That Bends. It Is Only Obama.


At a White House press conference this morning, ABC News reporter Jake Tapper asked President Obama to respond to a study by the government's Center for Medicare and Medicaid services released yesterday showing that, over the next ten years, total medical spending in the U.S. would rise slightly. For the most part, the president danced around the question, touting the law's headline benefits.

But eventually, he did note that, despite the projected increase, the average cost per family insured would drop. But as I noted yesterday, averages don't tell the whole story. And accepting the study's small cost-bump means accepting the dubious assumption that Congress would let physician's Medicare payment rates drop by 23 percent in December.

The other problem with this response is that when the president and his advisers first started talking about bending the cost curve, they weren't talking about average cost per family insured. They were talking about overall medical spending. "The only way I think we're going to fix it is if we see those two problems in the broader context of bending the curve down on health care inflation," the president told reporters in 2009. And if you look at the Commonwealth Fund's influential 2007 report on options for bending the curve, you see that the term was used was used to describe ways "to lower health spending relative to projected trends." Yesterday's CMS report projected that, in total, over the next decade, health spending will rise slightly more than if the law had not been passed. This is not a surprising result, really. Subsidizing health insurance for tens of millions more individuals was bound to result in some sort of immediate bump in health spending. And to his (sort of) credit, the president admitted as much. "As a consequence of us getting 30 million additional people health care, at the margins that's going to increase our costs." he told Tapper. "We knew that."