Monday, August 9th, 2010 - 16:32
Monday, August 9, 2010 - 15:57
What are the chances that the savings in Medicare projected by the latest actuarial report actually happen? And if not, how do we temper health care cost inflation?
Austin Frakt has an interesting commentary today (http://bit.ly/bF34dj) in the Kaiser Health News report that asks whether health care cost cutting solutions are more likely to come from the private sector than the government that ushered in health reform.
An upbeat report heralded by the administration found that health reform will extend the life of Medicare by 12 years. The caveat to this is that future congresses will have to be vigilant about implementing health reform the way THIS Congress intended it to be implemented. This has been described in numerous media reports as a "caveat" to the good news in the report. Given the increasingly polarized political climate, growing dysfunction in the Senate, and the bleak prognostications for the electoral fortunes of those most supportive of health reform, is it time to start considering these expected Medicare savings as fanciful-- and not just as a caveat? Those opposing health reform, after all, have often stirred up opposition to Medicare changes among seniors.
Consider this. As The Hill newspaper points out (http://bit.ly/aacmoP), the "report's conclusion hinges on Congress agreeing to a 30 percent cut in Medicare payments to doctors over the next few years, as well as cuts in funding to hospitals and other providers." That's a tall order for a Congress of little political polarization. It's beginning to sound more than a little fanciful for a Congress that's likely to be highly divided, filled with more members opposed to health reform, and dependent on a body that is increasingly requiring a supermajority to get anything done. Is it time to start asking whether making the health care cost cuts outlined in health reform will be a more challenging haul than passing health reform itself?
And, if so, what can be done about addressing costs -- which, sooner or later, have to be dealt with? Frakt says we might have to look at the private sector. He points toward consumer-driven health plans with high deductibles that may encourage consumers to be more careful about the kind of care they receive. We've written about this before on the blog (http://bit.ly/9DkKwx) with respect to a Wall Street Journal article reporting that Americans have been demanding less health care of late. How much faith can we place in these high deductible plans? Is there anything else the private sector can do? Is there anything less politically delicate than Medicare that a future Congress might agree upon even in times of intense polarization?