Opinion Column

Don’t Rationalize Busting The Budget – Start Over

I detect a growing rationalization among supporters of the Democratic health care bills: The recent flare-up over when a woman should have a mammogram proves we are nowhere near ready to pass a health care reform bill that will actually control costs. So, why bother?

You would be hard pressed to find any health policy expert who isn’t disappointed that cost containment has fallen off the health care “reform” express. In fact, it’s more commonplace to hear the term “budget-buster” when these bills are discussed.

Now, even many proponents of the bills are conceding there isn’t a lot of cost containment in them and beginning to argue that since the American people aren’t ready for real reform let’s just get on with passing what’s on the table.

But this rationalization misses something very important.

We already have high quality and lower cost health care being delivered around the country and people are not only supportive of it, they are flocking to it.

The Mayo and Cleveland clinics are touted as high quality and lower cost models for delivering health care services. Who wouldn’t want to be treated there?

The Dartmouth Atlas work has consistently shown that there are high-cost high-growth regions and there are low-cost low-growth regions. The conclusion has been that if the highest cost regions operated more like the lower cost regions America’s health care costs could be sustainable.

Yet, I have detected no public rejection in those low-cost areas because people believe they are getting poor quality health care. In fact, the Dartmouth data would seem to demonstrate that the quality of health care being delivered in the lower cost areas is better than in the higher cost areas.

The primary objective for health care reform always should have been more value for lower cost. It still should.

There is plenty of evidence that higher value health care for a lower cost is actually happening around the country and, when given a choice, that it is actually what patients prefer. Would you turn down an appointment at Mayo?

So, what do you say we ditch the latest rationalization for passing a budget-busting health care bill and start over. Since most of the benefits in the House bill don’t begin until 2013, and 2014 for the Senate bill, what’s the rush? We have plenty of time to take this back to where it should have been in the first place- beginning the long and complex journey to create a health care system that pays for value.

Categories: Cost and Quality, The Health Law