Word: careful
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...shenanigans they pull to deny claims when their enrollees get sick. It's true that real reform would enhance the economic security of working Americans. But let's face it: there are lots of ways to try to enhance the economic security of working Americans. You do health care first because the status quo is unsustainable. The most pressing health-care crisis is that we're spending way more than any other country, and we're getting results that are no better and sometimes worse. And the good news, for reformers at least, is that numerous studies have shown that...
...these days, Obama isn't saying much about cost-cutting. This is partly because most of his curve-bending ideas - computerized records to bring medicine into the 21st century, comparative effectiveness studies to identify unnecessary treatments, revamped incentives to reward quality rather than volume of care - would take more than a decade to start slashing costs, and the Congressional Budget Office (CBO) doesn't score bills for their impact on the federal deficit that far in advance. Obama's most prominent game changer - an independent panel to set Medicare reimbursement policies removed from political pressures - did not fare well under...
...pictures of health care protesters on LIFE.com...
...more like Santa and less like the Grinch. Cutting costs ultimately means cutting payments to drugmakers, hospitals, doctors, insurers and other influential health lobbies, so it's understandable that he hasn't dwelled on it. Providers like the Mayo Clinic have demonstrated the promise of high-quality, low-cost care, and mounds of research as well as books like Shannon Brownlee's Overtreated have documented Orszag's less-would-be-better thesis. But to laymen it can still sound like typically empty government promises to weed out waste, fraud and abuse. And the most prominent town-hall angle of attack...
...real cost restraints, and the early versions floating around Capitol Hill have been a bit disappointing. Obama has promised that reform will shift medical incentives from quantity to quality, from paying for volume to paying for outcomes. But except for a couple of demonstration projects designed to investigate why care costs so much more in some parts of the country, that hasn't been the focus of congressional legislation. "We've got to get the incentives aligned, or else we'll keep punishing excellent care, and we'll keep encouraging providers to do more procedures and tests and admissions...