What President Obama Is Reading On Health Care

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In Tuesday's "Playbook," Mike Allen reports, "Sources say President Obama declared that a Saturday blog post by Ronald Brownstein on The Atlantic's 'Politics' channel -- on how health reform would control costs -- was mandatory reading for all senior staff and that everyone involved in, or covering, the health care debate should see the piece."

You can read Brownstein's full piece, titled "A Milestone In the Health Care Journey," here. It makes the case, through statements from economists and Obama's budget director Peter Orszag, that the Senate health care bill does about as much as possible to "bend the cost curve" -- i.e., lower health care spending -- while also significantly expanding health care coverage.

Here's a taste:

In their November 17 letter to Obama, the group of economists led by Dr. Alan Garber of Stanford University, identified four pillars of fiscally-responsible health care reform. They maintained that the bill needed to include a tax on high-end "Cadillac" insurance plans; to pursue "aggressive" tests of payment reforms that will "provide incentives for physicians and hospitals to focus on quality" and provide "care that is better coordinated"; and establish an independent Medicare commission that can continuously develop and implement "new efforts to improve quality and contain costs." Finally, they said the Congressional Budget Office "must project the bill to be at least deficit neutral over the 10-year budget window and deficit reducing thereafter."

As OMB Director Peter Orszag noted in an interview, the Reid bill met all those tests. The CBO projected that the bill would reduce the federal deficit by $130 billion over its first decade and by as much as $650 billion in its second. (Conservatives, of course, consider those projections unrealistic, but CBO is the only umpire in the game, and Republicans have been happy to trumpet its analyses critical of the Democratic plans.) "Let's use the metric of that letter," said Orszag, who helped shape the health reform debate for years from his earlier posts at CBO and the Brookings Institution. "Deficit neutral; got that. Deficit-reducing second decade, got that. Excise tax: That was retained. Third is the Medicare commission: has that. Fourth is delivery system reforms, bundling payments, hospital acquired infections, readmission rates. It has that. If you go down the checklist of what they said was necessary for a fiscally responsible bill that will move us towards the health care system of the future, this passes the bar."

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