Don't Hold Your Breath for Lower Health Care Costs

Yesteday, I attended a briefing at the National Press Club here in beautiful downtown Washington, D.C. The subject: Would the health care plans put ...
June 4, 2008

Yesteday, I attended a briefing at the National Press Club here in beautiful downtown Washington, D.C.

The subject: Would the health care plans put forth by the presidential candidates put the brakes on health care costs?

The panel discussing this question was extraordinary: Uwe Reinhardt, the health economist from Princeton; Mark McClellan, who headed up CMS until a year or two ago (and whose brother is now very famous); and Paul Ginsburg, a heavy-weight thinker who is in charge of the Center for Studying Health System Change.

The quick answer to the question asked of the panel: No -- not for all the candidates' support of health information technology and access for all.

But the bigger question lurking within the ongoing discussion was whether health care would be a major issue in the coming months of the presidential campaign and whether the new president and the new U.S. Congress would be likely to tackle the issue in 2009. 

The panelists agreed that health care would fade as a major issue, overtaken by the economy and possibly by the war in Iraq. As to whether it would surface on the legislative agenda, my takeaway from things said and unsaid by the panelists: Health care reform will still be up to the states. The Massachusetts approach -- public programs for low-income people and a healthy reliance on private insurance for everyone else, plus an insurance exchange to help people sort things out -- is the model most states will follow, with their own variations.

And if Congress did address the issue, the panelists saw it as unlikely that there would be a Medicare-for-All approach. Rather, Congress, too, would look to a Massachusetts-type plan.

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