While health care reform advocates and longtime chroniclers of the issue are expressing sincere pleasure with Monday's announcement that key stakeholders are going to work together to cut $2 trillion in health care costs, a thread of skepticism persists.
That's because the plan itself has no demonstrable method for holding the industry players to their word -- whether it be to better coordinate coverage, lower administrative costs, streamline payments or improve electronic records.
The White House, pressed on the matter during the day's briefing, did little to dispel the concern. The main accountability mechanism, it seems, will be the press, in addition to the notion that word is bond when it comes to the president.
"Well, the president in meeting with the group this morning, before they went out he said to this group, 'You've made a commitment. We expect you to keep it,'" said press secretary Robert Gibbs, during Monday's briefing. "And I think there's pretty good conceptualization of the baseline for health care spending. And I know on some of the calls over the weekend, this isn't something that CBO will score [which would provide a clear indication of whether the reforms were being implemented]. But... you guys all do stories, and we certainly watch the amount of health care inflation each year. And I think people believe that there is a sufficient ability to track whether or not these reforms are being taken."
Gibbs went on: "We certainly believe that the players that are involved and the trade associations that they represent are genuinely serious about moving health care reform forward. But we will be, certainly, evaluating throughout this process how effective they're being, how effective the government is being at curtailing costs for Medicare and Medicaid in hopes of making sure that that savings are realized by American families."
There is a certain element of truth to the notion that today's health care landscape will compel a greater commitment towards lowering costs and increasing access than produced by voluntary efforts in the past. But some notable observers in the health care reform debate -- from reporters to advocates -- are a bit skeptical that this go-around will be dramatically different. That said, if the industry can even come close to reaching the $2 trillion mark in spending reductions it would be a remarkable, albeit hard earned, achievement.
"I don't want you to think that altogether it is going to necessarily be a wave of a wand," said Gibbs. "But I think that what is important about this is that you have all of those involved, ready, willing and able to make a concerted effort, take concerted steps, in order to demonstrate they are serious about health cost. I think in many ways that is a huge step that the president realizes is a big step toward reform."