Thursday, July 14, 2011

CBO Chief Doubts Obamacare Delivery Reforms Will Work

Kaiser Health News reports on a Tuesday speech by Congressional Budget Office Director Doug Elmendorf, who indicated that CBO would be releasing a report “show[ing] that more than two dozen demonstrations [sic] projects launched by Medicare and Medicaid over the past decade have failed to stop the upward march of health care costs.”  The Kaiser story quotes Dr. Elmendorf as saying that “The demonstration projects that Medicare has done in this and other areas are often disappointing.…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.”

The entire premise of Obamacare is that these types of delivery system reforms – guided by the federal government, and particularly Obamacare’s new board of unelected and unaccountable bureaucrats – can reduce the growth rate of health spending.  But the non-partisan head of the Congressional Budget Office has expressed robust skepticism that this type of top-down, bureaucratic tinkering – an intellectual elite of bureaucrats ruling in a far-off capital – can drive the improvements needed to reduce cost growth.

The only options left in the Democrat toolchest would appear to be arbitrary rationing mechanisms – either explicit rationing through the denial of treatments and procedures, or de facto rationing by reducing reimbursement levels so low patients cannot obtain care.  There is of course another way, and that’s to empower doctors and patients, rather than bureaucrats, to deliver better care.