Some Health Care Cost Containment Measures

TW: Ezra Klein from WaPo has aggregated some key thinkers' thoughts on health care delivery cost containment. These are the nitty gritty details of legislation which, after all of the hyperbolic "debate" re death panels etc., could actually make differences. Is your congressperson working on these details or merely demagoging? These are also the type details media do not cover for the simple reason if they did no one would watch. Below are some snapshots:

" '...Medicare has to lead the way in moving away from a system that rewards low value, high cost services and undercompensates for time spent with patients to help manage or even prevent illness. Provisions in the Finance bill encourage innovation -- not just by creating a Center for that purpose -- but by empowering it to broadly experiment with new payment mechanisms, requiring their evaluation, and authorizing their broader implementation.
But equally important...are the provisions in both the House and Senate bills to authorize changes in the existing payment system to re-price services that are just plain over-priced. Until we stop paying too much for the wrong kind of service, we won't get providers to deliver the right kind of service. Getting the current payments right, then, is as important to change as putting new kinds of payments in place...'
--Judy Feder is...dean of the Georgetown Public Policy Institute, and a health-care policy expert at the Center for American Progress.

'Successful cost control requires two strategies: (1) aggressive government bargaining to constrain prices and utilization, and (2) the development of new care models that provide more efficient care. For now, the first strategy seems out of reach. Democrats choose to blame insurance and pharmaceutical lobbies. In truth, the opposition is broader.

I am becoming more optimistic about the second strategy. I don’t know whether accountable care organizations or primary care medical homes really save money...

I’m also struck that these efforts enjoy wide support among partisans who normally disagree. As a partisan myself, I have no trouble identifying friends and enemies in the fight over universal coverage. When I ponder delivery reform, I find the white hats and black hats more difficult to place. However liberal and conservative experts might disagree over the public option, both want to shift resources from specialty to primary care. Both want Medicare purchasing through competitive bidding. Both want medical care to be explicitly guided by comparative effectiveness research...'
--Harold Pollack is a professor at the Univ. of Chicago, a faculty chair of the university's Center for Health Administration Studies

'Baucus...has a little noticed but very important provision to establish a Chronic Care Management Innovation Center at CMS. The Center, funded at $1 billion per year, would experiment with different ways to encourage evidence-based, coordinated care. Reforms that improve quality and reduce costs could be expanded nationally without further legislation.
Improved chronic care management is a key part of necessary reform. It is what will turn the dream of prevention into a reality, improving health and saving money. Further, the idea of experimentation is exactly right. We don’t know all the steps to take in reform. But we have a number of ideas. Those ideas should be tested, refined, and then expanded or dropped as appropriate. The chronic care management center is a model for how payment reform might work as a whole'
--David Cutler is Dean of the Social Sciences...Professor of Applied Economics at Harvard University...He was also one of the Obama campaign's most influential health-care policy advisers.