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Reforming Delivery
Liberals Borrow GOP Ideas for Controlling Health Care Costs

The Center for American Progress might have done that rarest of things: produced a partial health care reform plan that appeals to many on both sides of the aisle. Taking both Republican and Democratic ideas together, the DC think tank has proposed a way forward on cost control despite the dysfunction that surrounds the health care debate. WaPo lays out the details:

Individual states would set their own targets to curb the growth of health care spending. If they succeed, they’d pocket a share of federal Medicare and Medicaid savings, ranging from tens of millions to $1 billion or more, depending on the state. […]

The proposal is also a sign of Democratic sensitivity to a major piece of unfinished business for Obama’s Affordable Care Act — cost control. “Obamacare” remains politically risky for Democrats in this fall’s political campaigns. […]

“It’s got some Republican roots to it, and it’s got some Democratic roots to it,” said Ezekiel Emanuel. “We wanted to create a bipartisan proposal that does take advantage of some Republican ideas and is cognizant of Democratic concerns, and use it to transform the whole delivery system.”

CAP staffers plan to take this around to the White House as well as Congress. It might get at least some hearing at the WH, given that CAP’s former president John Podesta now advises President Obama. But even if it doesn’t make its way in the legislative process just now, this proposal is significant for a few reasons. For one, it signals a willingness of health care scholars on the left to acknowledge that the ACA, whatever else it might have done, basically did not address our cost problem, and that future attempts to tackle costs on the federal level might not be particularly effective or politically feasible. That’s an important step forward—but more important is the proposal of a plan with bipartisan roots to address the cost problem itself. Given how little bipartisanship accompanied the ACA’s passage, this is a welcome change. It could even be the canary in the coal mine for where the health care discussion could, with a little luck, start going.

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  • Jacksonian_Libertarian

    The Government Monopoly can’t be fixed, it lacks the same thing all monopolies lack, the “Feedback of Competition”. It is the “Feedback of Competition” that forces continuous improvements in Quality, Service, and Price, in free markets. The only way to limit the waste, incompetence, and corruption in the Government Monopoly is to limit the size and scope of the Government Monopoly to only those tasks only a government can do (Defense, Justice, Foreign Relations) and leave everything else to the free market.

  • FriendlyGoat

    Let’s hope the White House is not swayed to politically stupid ideas because they like John Podesta. Democrats succumbing to Republican ideas for this are as useless as bird dogs who entrust their field training to cats.

    The answer to health care cost control is price transparency and price publicity, 24/7/365, so that all players are always up to date and focused on prices. The “players” are politicians, media, insurance buyers, employers, and citizen watchdog groups.

    In health care, the players are NOT the patients. When people are sick or the lives of loved ones are threatened, it is NOT the time for anyone to “go shopping for the best deal”. Only complete morons talk about health care policy in these terms or with this implication.

    The best deal is something that should be constantly produced by every force in society EXCEPT the sick patient and his/her family.

    Health care is not used cars, fast food, appliances, grocery coupons, hotel discounts, frequent flyer miles or ANY of that “shopping around” business. We are a goofy society until we come to this realization.

  • Andrew Allison

    How about this for an idea: the Federal government dispenses per capita Medicare and Medicaid revenue, and lets the States solve their own problems?

    • FriendlyGoat

      How about this for an idea: The federal government takes its hands completely off of education—-leaving all regulatory responsibility and funding to the states? In return, the states step completely back with respect to health care, with all responsibility, licensing, standard setting and funding handled by the federal government?

      Education is not a matter of life or death—–or personal bankruptcy. It is uniquely suited for state-level arguments and periodic bungling because it need not even involve interstate commerce. Citizens deserve, however, a set of national standards and expectations for health care, in the same manner that we do not entertain fifty versions of the FAA or the National Weather Service.

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