The current reorganization of health care could make it better and cheaper for everyone, harnessing real creative and competitive energies to build the “next health care” —or it could lead to local monopolies, higher prices and less real competition where it matters. The many and various moves toward accountability, competition and transparency could defeat themselves.
The theme of the reorganization is clear: new types of cooperation between physicians, hospitals and other providers that cut down on duplication and unnecessary procedures and tests; that make the system accountable both for processes and outcomes; and that share economic risk among the providers. This new and strange cooperation comes in many types, typically labeled “accountable care organizations” (ACOs), “bundling,” “patient-centered medical homes” (PCMHs) and “co-management.”
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Category: Policy | Tags: Health reform | No comment
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Australia, as you may have heard, is an English-speaking settler state where a new center-left government took office in early 2008 with an ambitious agenda of progressive reform. But both under Kevin Rudd and under Julia Gillard, the governments in question have had trouble in practice getting a legislative agenda through the veto points and hurdles of the system. How it’s played out in detail is quite different, but in an abstract sense, Australia is not on some wildly different social or public policy trajectory in the United States. And yet as Karl Smith points out, the Australians keep seeming to be forgetting that regulatory uncertainty and/or bad luck from Europe make it impossible for a high productivity society with a growing population to continue to increase its output:
A closely-watched measure of Australian consumer confidence rebounded strongly in September as lessening fears of a hike in interest rates and better news on the economy helped offset turmoil on global markets. [...]
“This is a surprisingly strong result,” said Westpac chief economist Bill Evans.
He thought it likely that diminished fears of a rise in rates from the Reserve Bank of Australia (RBA) may have helped sentiment. The central bank made it clear last week that it was best for policy to stay on hold while markets were so volatile.
What? What? It reminds me of, I dunno, 1997 and 1998 when “bad stuff” would happen in the world (Russian default, hedge fund wackiness, blah blah) and policymakers in the United States of America had a firm conviction that “lets have several million additional people sitting on the couch, unemployed and depressed” wasn’t going to make things any better. They of course could have chosen to let the economy fall into a deep depression and then said, “look we didn’t make this depression, it’s the banking crisis in Asia and market turmoil prompted by Russian default. Also Chiapas. Go blame Subcommandante Marcos.”
Is there some conservative explanation of why there’s less regulatory uncertainty in Australia than in the United States?
from: http://feedproxy.google.com/~r/matthewyglesias/~3/WCr68oYD0G4/
When Medicare was established, it had two parts, A and B. Part A pays for hospitalization and is financed by a payroll tax that all workers pay. Part B pays for doctors’ visits and is voluntary. Its cost is financed by premiums paid by beneficiaries and by general revenues.
Originally, beneficiaries paid for 50 percent of Part B’s benefits. But in 1973, the law was changed and the percentage of benefits covered by premiums fell steadily until 1985, when premiums were fixed at 25 percent of the program’s costs. Thus if beneficiaries still paid as much of Medicare Part B’s costs as they originally were supposed to then federal revenues would be $65 billion higher this year.
And here’s the kicker: higher Part B premiums wouldn’t count as higher revenues, but as lower spending for Medicare. Therefore, it would not be a tax increase, would not violate the sacred pledge and would cut Medicare, which Republicans all say they want to do.
Full Bruce Bartlett column worth reading.
from: http://feedproxy.google.com/~r/TheJohnGoodmanHealthBlog/~3/t2ID-HyUKF0/
