President Obama spends this weekly address dealing with health care and energy, with an accent on agreement reached by major stakeholders in each area. The health care agreement has garnered a lot of press, with some of the same folks who had opposed the Clinton health care initiative offering to work together to slow the unsustainable rate of increase in health care costs.(Their letter to the President is attached below). The President commented on Monday. From the New York Times:
In remarks prepared for delivery to health care providers on Monday, Mr. Obama says: “These groups are voluntarily coming together to make an unprecedented commitment. Over the next 10 years, from 2010 to 2019, they are pledging to cut the growth rate of national health care spending by 1.5 percentage points each year — an amount that’s equal to over $2 trillion.”
“Reform is not a luxury that can be postponed, but a necessity that cannot wait,” Mr. Obama says.
The President is staking plenty on an ability to finally get under control the cost of health care, which is destroying budgets and killing jobs everywhere. But even this letter only holds down “the rate of increase”. And real cost containment, which would provide tangibile relief, will be fought hard. The same NY Times story includes an observation, which I think is accurate.
In the abstract, slowing the growth of health spending is a goal on which consumers and health care providers agree. But experience shows that specific proposals touch off fierce battles among interest groups fighting to expand their share of health care money.
And that brings us to the latest David Brooks column in the Times, which agrees that Obama’s entire strategy revolves around ramping up spending in order to get health care costs under control, and via the savings achieved putting our fiscal house back in order. Brooks also agrees that some of the Obama proposals are good public policy, and point us in the right direction. But ultimately Brooks feels that the severity of the problem requires what might be politically untenable solutions, and that Obama will fail to generate the savings necessary to justify the current deficits. The title of his column “Fiscal Suicide Ahead” gives his central thesis away. From Brooks:
If you read the C.B.O. testimony and talk to enough experts, you come away with a stark conclusion: There are deep structural forces, both in Medicare and the private insurance market, that have driven the explosion in health costs. It is nearly impossible to put together a majority coalition for a bill that challenges those essential structures. Therefore, the leading proposals on Capitol Hill do not directly address the structural problems. They are a collection of worthy but speculative ideas designed to possibly mitigate their effects.
The Brooks column is a good read even if you do not agree. If you tend to agree then it could be argued that our political system, as it works today, will not allow serious cost containment on health care, ever. And then we will be stuck forever with a system that will bankrupt us as a nation.
Bill Manzi.com 