Too Little on What Controls Costs

Robert Reich’s comment stating the President’s speech should have been clearer about how his plan will contain future costs was right on the mark. See his blog posting below.

More than a week after the Presidential speech to Congress there still has not been any indication or revelation on how the administration intends to reign in the high cost of care that continues to grow at an unacceptable level.  While President Obama wasted no time bashing insurance companies for their unjust practice of dropping coverage for preexisting conditions or other catastrophic illnesses, he failed to touch upon or address the crux of healthcare reform: containing cost.

At no point was there mention concerning the myriad of components that contribute to the rise in health care costs such as physicians, hospitals, pharmaceutical companies and other entities all entrenched in our current health care system. It is true that insurance bureaucracies contribute to the rise in health care costs, they themselves are not the lone culprit. The fact is, there are so many moving parts to this byzantine system, all of which contribute to rise in costs. This is a fact that can’t be ignored by the Administration, Congress or anyone wanting to promote real change to the system. Without controlling the increasing rise in costs, any plan is doomed for failure.

Robert Reich, a professor at the Goldman School of Public Policy at the University of California at Berkeley, was secretary of labor in the Clinton administration. He is the author, most recently, of “Supercapitalism,” and he blogs at Robert Reich’s Blog.

The president’s rebuttal of the fear-mongers was strong and he made a compelling case for preventing insurers from denying coverage because of pre-existing conditions or dropping coverage because of a serious illness and for requiring all Americans to have health insurance. He clarified his goal of full coverage and his support for a public insurance option.

He should have been clearer about how he intends to pay for the coverage of Americans who can’t otherwise afford it.

But I thought he should have been clearer about how he intends to pay for the coverage of Americans who can’t otherwise afford it, and how he’ll contain future costs. A commission to look at health outcomes is a fine idea but how are its findings to be used and enforced?

Taxing high-cost insurance plans is worthwhile but won’t raise much money or dramatically reduce future costs. An optional public insurance plan that’s open to all would put competitive pressure on private plans to reduce costs while also pressuring drug companies and providers to do the same, but his version of a public option would be available only to a relatively small number of Americans who lack employer-provided care.

The proposed health care exchange could generate real savings if the federal government acts as gatekeeper and limits access only to private insurers that offer low prices and high quality, but he didn’t explain the government’s role.

Still, he recaptured the initiative on health care and provided some cover for conservative and Blue Dog Democrats who need it in order to vote for the plan — which, I assume, were his most immediate political goals.