The health care industry is playing its final card. Even the Republican Party is ready to "throw the health insurance industry under the bus," according to strategist Frank Luntz -- while taking every opportunity to block all reform proposals.
To avert genuine cost control, the industry is promising to voluntarily hold down prices, per a letter from the America's Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America; as well as the AMA, the Hospital Association, the Advanced Medical Technology Association, and the Service Employees International Union. Voluntary efforts have been effective in the past at staving off real health reform, but each time have failed to truly reduce costs.
To avoid the political fight of imposing genuine cost control, the Administration may accept the offer. Advocating health reform as a measure to help save the failing economy, it has suggested reducing costs by transforming how health care is delivered. An array of sensible and important proposals, from increasing primary care and incentives to improve quality, to addressing the social and economic causes of illness, are on the table. These proposals are well and good. Our fragmented, profit-driven system means that Americans spend more for using fewer health care services, and get worse health outcomes, compared with other countries. Improving care will help some people.
But the Congressional Budget Office has testified that it will not give much credit to these proposals for savings on costs. CBO and the health care industry know what would work, and it's the third rail of the current debate: In every other country, the government takes responsibility for assuring that health care is affordable and available. Since they know individuals can't bargain over prices when they're sick, the government does it for them, by setting limits on total health care spending, and prices.
We're mustering the political will. The question is, will Congress propose a plan like Medicare, that can ensure the government can play its role, and hold down costs while assuring universal coverage? Let's look for robust proposals that can secure the transformation of the health system that policymakers are promising.