Ruth Marcus has a sensible column on cost controls in the Senate health-care bill today. After running through some of the estimates -- some say the bill will save a lot of money, some say it will save a bit of money, and some doubt the proposed savings will materialize -- she concludes:
Let's hope the higher savings materialize -- but include a backup plan if they don't. The Senate measure already contains a mini-version of such an approach: A new Independent Medicare Advisory Board that would recommend changes, subject to an up-or-down congressional vote, if costs grow faster than a preset target. Virginia Democratic Sen. Mark Warner has usefully proposed expanding the board's mandate to include recommendations for controlling private-sector health costs -- though these, unlike the Medicare proposals, would not have a fast track to congressional approval.
Right now, the best cost-control measures on the table are Warner's package and the Rockefeller-Lieberman-Whitehouse improvements to the Medicare Commission. I don't know of much else on the table that will lead to serious curve-bending. But there's still a bit of time.
But from the perspective of consumers, the insurance regulations will be very important in keeping average premiums low and product quality high. That means you need a strong individual mandate, a tight cap on what insurers can spend on things that aren't medical payments, sharp limits on their ability to discriminate on the basis of age, really good risk adjustment (so there's no incentive to cherrypick), and aggressive oversight of annual limits, rescissions, and similar practices (none should be allowed). This discussion has been impeded by the fact that new insurance regulations were sent to CBO as part of the compromise proposal, but we don't know what they are yet.
Source: http://feeds.voices.washingtonpost.com/click.phdo?i=fc158e5eb4c53235b387946e6a81237d
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