Health Reform: Costs, Variations in Care & Public Insurance

Wall Street Journal

A brief commentary from the WSJ on-line regarding some of the issues evolving around healthcare reform.  One thing is for sure, healthcare costs vary to the extreme from one end of the country to other and lack any apparent uniformity.  Something to take note of the next time you receive a medical statement and/or bill and are alarmed by the actual charge.

The health-reform theme of the day seems to be widespread variations in health-care costs in different areas around the country. If one city spends twice as much as another on health care without any noticeable benefit for patients, the thinking goes, there must be a way to find some savings.


This is an old idea among health wonks (see the Health Blog’s 2007 interview with Dartmouth’s Jack Wennberg, who has been talking about this for decades), but it has gained currency lately amid the big health-reform push in Washington.
Congress may wind up capping Medicare payments in areas where costs are unusually high, or sparing low-spending regions from cuts in Medicare reimbursement, the New York Times notes in a story today.


In 2006, this morning’s Washington Post notes, Medicare spent $5,812 on the average beneficiary in La Crosse, Wisc., compared with $16,351 in Miami, without clear evidence that the extra spending resulted in better care.


Meanwhile, the WSJ reports today, we could start seeing the first proposed health-reform bill as soon as this week from a Senate committee, the start of a stream of health-reform legislation likely to flow from different committees in both houses in the coming months. Congress is aiming to pass legislation by August and deliver a single bill to President Obama by October.


Two key debates remain central, the WSJ notes. One is whether to include a national, government-backed insurance plan; a group of Republicans from the powerful Senate Finance Committee sent a letter to Obama on Monday reiterating their opposition to a public plan, which the administration backs. The other debate is, of course, how to pay for health reform. One possibility to keep an eye on: taxing some health-benefit plans, an option we discussed in this post.