CBO: Obama Care Reforms Will Not Control Costs
A forthcoming report from the Congressional Budget Office shows that more than two dozen demonstrations projects launched by Medicare and Medicaid over the past decade have failed to stop the upward march of health care costs… CBO director Doug Elmendorf … defended CBO’s projections that delivery system reforms like the accountable care organizations allowed under reform would only save a few billion dollars in the coming decade. “The demonstration projects that Medicare has done in this and other areas are often disappointing,” he said. “It turns out to be pretty hard to take ideas that seem to work in certain contexts and proliferate that throughout the health care system. The results are discouraging.”
Full story here.
See Aaron Carroll’s post on this study at the Incidental Economist.
See my comment on the post and Aaron’s reply. He endorses rationing.
I like the idea of experimentation. But it doesn’t surprise me that many of the demonstration projects have not panned out. Many of the demonstrations’ rules are rigid, where participants cannot adjust their methods as lessons are gleaned from the project.
The current theorists in Medicare/Medicaid are colloquially “The Borg”. They are certain, all together, that their higher intelligence and dispationate love for statistically determined medicine is the best for the mass of humanity which must be assimilated.
They were hyperlinked while attending elite colleges and working as assistants to politicians. They belong to a subtle and powerful network. We plebians will never know the joy of that interconnection, nor the joy of having government and academic health benefits which exclude them from the enlightened policies which they will administer.
These are the people who hated mathematics and statistics in college, and didn’t understand them one bit. Now, they embrace the results of any statistical “study” lumping together the medical results of thousands, to produce a one-size-fits-all protocol to reduce costs, forced on everyone who is non-Borg.
Their motto: “I have found my calling in life as an efficiency expert.” They dream of returning to the 1950’s. They think that progress will come from standardizing the assembly line, rather than inventing new products.
The CBO has been consistent about this and the evidence shows they have been consistently right.
Not gonna work!!
I wonder at Professor Berenson’s statement: “There are positive elements in a lot of those demos,” he said. “You could pick and choose the ones that worked.”
Who is free to pick and choose the ones that worked? Certainly not providers bundling and rebundling services in response to demand by patients in their communities: Laws and regulations largely prevent that.
In a free society, everybody is free to pick and choose what they believe will work. We don’t know where or when it will work, or where and when it will stop working, or where and when it will re-start working again.
The ever increasing level of government control in U.S. health care prevents the picking and choosing that Prof. Berenson endorses.
Given the flood of e-mails and brochures I receive inviting me to webinars and conferences to learn about how to get on board the next, exciting, Medicare or Medicaid pilot, I expect that these pilot programs have become an industry unto itself.
That is, the funded don’t actually expect to learn something that they believe can expand in the marketplace, but just spend the funds granted and then go back to the well for more funding for yet another pilot project.