Reining in Healthcare Costs
Ronald Brownstein on the cost-control measures in the Senate healthcare reform bill:
[Jonathan] Gruber is a leading health economist at the Massachusetts Institute of Technology who is consulted by politicians in both parties. He was one of almost two dozen top economists who sent President Obama a letter earlier this month insisting that reform won't succeed unless it "bends the curve" in the long-term growth of health care costs. And, on that front, Gruber likes what he sees in the Reid proposal. Actually he likes it a lot.
"I'm sort of a known skeptic on this stuff," Gruber told me. "My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. They really make the best effort anyone has ever made. Everything is in here....I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing."
....In their November 17 letter to Obama, the group of economists led by Dr. Alan Garber of Stanford University, identified four pillars of fiscally-responsible health care reform....[Mark] McClellan, the former Bush official and current director of the Engleberg Center for Health Care Reform at the Brookings Institution, was one of the economists who signed the November letter. McClellan has some very practical ideas for improving the Reid bill (more on those below), but generally he echoes Orszag's assessment of it. "It has got all four of those elements in it," McClellan said in an interview. "They kept a lot of the key elements of the Finance bill that I like. It would be good if more could be done, but this is the right direction to go."
McClellan is being honest here: it would be nice if more could be done to rein in costs (it would always be nice if more could be done, wouldn't it?), but the Senate bill is still pretty good. It includes all the primary elements of healthcare cost control and gets us moving in the right direction.
It's noteworthy how much support healthcare reform has from retired Republicans compared to the zero support it has from active Republicans. The Senate measure is basically a pretty good bill considering the political environment it's being built in, and lots of Republicans who aren't running for office see that. But Republicans who are running for office aren't allowed to admit any of this. Not because the bill is bad, but because their political careers would be ruined by taking any of this stuff seriously. Sad.
Via Ezra. As he says, it's a very good, detailed column. Worth a full read if you want to understand more about how the Senate bill gets the ball rolling on healthcare cost control.