Obamacare

The Buy Now, Pay Later Strategy For Health Care Reform

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At this point, outside the administration and its most ardent supporters, it's fairly widely accepted that the new health care law won't sufficiently address the unsustainable growth of health care costs. Congressional Budget Office director Doug Elmendorf, for example, has said that "rising health costs will put tremendous pressure on the federal budget during the next few decades and beyond.  In CBO's judgment, the health legislation enacted earlier this year does not substantially diminish that pressure." Former CBO director Alice Rivlin (who supported the health care law) recently told Business Week that when it comes to long-term budgeting and deficit reduction, the "central issue" remains "reducing the rate of health care growth." And now The Washington Post's Alec MacGinnis points out that although the law includes some reforms designed to reduce the overuse of medical care, little in the law is expected to make a difference in terms of health care prices.

MacGillis suggests that if the law had focused on price reductions, perhaps by including a government-run insurance option, it might have been more popular. Ignoring the policy problems with a government-option for a moment, it's worth remembering that broad public opinion wasn't the only popularity measure that legislators had to worry about: Big stakeholders in the health care sector had to be brought on board in order to avoid an industry-vs.-government PR war. If HillaryCare is any lesson, an air battle with doctors and drug makers, both of whom ended up supporting reform, would've had a pretty significant negative effect on the law's popularity.

The other, related thing to remember, though, is that despite all the chatter about bending the cost curve and reducing costs, failing to address the long-term cost issue was the explicit legislative plan of attack all along. MacGillis hints at this in her final paragraph, when he quotes Brookings budget scholar Henry Aaron arguing that "if we attacked costs right at the front end, [the legislation] would have died….Now, we'll have a mechanism that will force us to address it. There are only so many fronts you can fight a war on at the same time." In other words, we have two problems. First, the ship is slowly sinking. Second, not everyone is on it. We chose to bring most of the swimmers onto the decks, but long-term, the boat is still going to sink. It's the Buy Now, Pay Later strategy, and we're going to be paying for it for a long time.

NEXT: Good Luck, America!

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  1. Blogwhoring

    Sugarfreeing: Posting a link to your crap on Reason’s H&R comment section

  2. “The new health care law wasn’t supposed to undercut employer plans..”
    Does anyone think Pelosi had the slightest clue as to what was supposed to happen?

    And:
    “What we are hearing in our meetings is, ‘We don’t want to be the first one to drop benefits, but we would be the fast second.'”
    Of course. The first one will be blamed as a nasty corporation.

    http://www.sfgate.com/cgi-bin/…..1G1COR.DTL

  3. noun, verb, Obamacare’s bad
    noun, verb, Obamacare’s bad
    lather, rinse, repeat

  4. We may be paying sooner than later.

    http://www.kaiserhealthnews.or…..ation.aspx

    Despite pledges to leave employer-based health plans intact, benefits consultants say some firms are considering ending or reducing coverage for their workers, The Associated Press reports, adding: “That’s just not going to happen, White House officials say.” But an executive for the consulting firm Deloitte said, “What we are hearing in our meetings is, ‘We don’t want to be the first one to drop benefits, but we would be the fast second.’ We are hearing that a lot.”

  5. MacGillis suggests that if the law had focused on price reductions, perhaps by including a government-run insurance option, it might have been more popular.

    As a bona fide libertarian who thinks the best health care system would be free market-based, I have to say that a socialist, single payer system would make more sense and would work better than whatever-the-hell-it-is bastardized worst-of-all-worlds system we now have as a result of Obamacare “reforms”.

  6. Just exactly how is a “public option” supposed ot reduce health care costs?

    All it does it transfer them to the taxpayers. It doesn’t *reduce* anything!

    And this notion that we’re going to get rid of the waste in the healthcare system by squeezing the insurance companies? Pure insanity. The insurers aren’t the ones wasting money. It’s the doctors and the hospitals. The insurers are the only people who DON’T want to waste money. Squeezing them isn’t going to do jack shit.

  7. “an air battle with doctors and drug makers, both of whom ended up supporting reform”

    No we didn’t. The AMA does not equal “doctors”. I sure didn’t support reform and the last time I checked I’ve got an MD after my name. The AMA represents only about 30% of physicians and its membership was quite divided as to whether or not to back the bill. The trick that was pulled was dangling a repeal of the sustainable growth rate formula, which would cut physician pay dramatically. Of course, that hasn’t happened. Basically, the AMA got bought off with deception. I hope they learned their lesson, but something tells me they didn’t. Again.

    1. Meaning that the SGR cuts pay. Repealing it would increase pay…just realized that seems confusing.

  8. Reason needs to replace this repeticious fuck as pointman on health care reform.

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