Our Spending Is Your Revenue

TW: Have posted on this before, but health care spending much like defense spending and many others is a huge business. Efforts to cut that spending will be opposed fiercely by entrenched interests. I disagree that conservatives are the strongest opponents of cost cutting, I regard it as thoroughly bi-partisan problem. Democrats have at least proposed two initiatives to cut spending- squeezing health care provider margins and CER (comparative effectiveness research). The Republicans largely oppose both initiatives, where are their solutions?

From Ezra Klein at WaPo:
"...Between 2003 and 2006, Republicans held the White House and enjoyed a substantial majority in the Congress. Did anyone notice an aggressive effort at cutting costs in the health-care reform system? No? Me neither...

...People don't like to cut costs in the health-care system. It's painful. Politicians do not voluntarily do painful things. But a lot of people want to achieve universal health care. And they're willing to make a lot of concessions to do so. The coverage expansion, in other words, can serve as leverage for the cost controls. If Republicans wanted them to.

...Republicans have gone after comparative effectiveness review and Medicare reform. They've attacked cuts in reimbursements to Medicare Advantage plans and rejected efforts to bargain down drug pieces. They have demagogued the Federal Health Board and shown no enthusiasm for empowering MedPAC. The Healthy Americans Act, which actually would cut costs...Nor have conservatives come forward with a menu of cost-cutting options that Democrats could adopt in return for Republican votes.

In response, Democrats are doing exactly what you'd imagine: They are abandoning cost controls because they recognize that they can't survive the attacks that Republicans will mount against them. That's what happened to the employer tax exclusion this week. But there are many in the Democratic caucus who would far prefer a bill with serious cost-cutting measures and a hefty set of Republican votes. The deficit hawks, in fact, are a bit desperate for such a deal, because they know this is their best chance to cut costs in the health-care system, and they know they can't do it without Republican cover. But no Republicans are offering them that deal, because most of the Republicans think their first priority is killing this bill, not using it as an opportunity to control costs"