COST: Can the Presidential Candidates Plans Get the Job Done?

Will the candidates plans really bring down health care costs?

The Alliance for Health Reform (if there are any uninitiated among our readers, their http://www.allhealth.org/ web site is a health policy treasure trove) invited three health policy experts to answer the delicate question: Do any of the three major candidates' health reform cost containment plans really do much to contain costs?

The answer from all three, at least at this discussion, fell somewhere between a "not clear" to "not much." At least that's how Princeton's Uwe Reinhardt said he would answer if you gave him "some truth serum—or a couple of glasses of wine."

Reinhardt, Paul Ginsburg of the Center for Studying Health System Change, and Brookings' health guru Mark McClellan, who ran both Medicare and the FDA under President Bush, all approved of many of the cost containment ideas that the candidates had, ideas like more coordinated care, preventive medicine, changes in how we pay doctors, evidence-based medicine, even possibly some kind of malpractice reform if lawmakers can ever find a version they can agree on. And they spoke approvingly of the fact that both parties were now focused on these measures, which should also improve the quality of health care. But none of the three experts were very sanguine that these steps alone would trim costs dramatically in the short-term. Reinhardt did note that the cost containment suggestions being talked about by the candidates would produce more value for the buck, which is good, but wouldn't do much to change the number of bucks.

For instance, John McCain, Hillary Clinton, and Barack Obama all call for more health information technology and embrace its potential savings. But IT's ability to contain costs in and of itself "is very uncertain," Ginsberg said. He said IT will help quality, but the technology has costs as well as savings.

McClellan said that policymakers have talked a lot more recently about how to fix aspects of care—but nobody is paying enough attention to the administrative costs in the U.S. system, which are much higher than in other industrialized nations. There's lots of talk about how Medicare can drive changes in the health system but the former Medicare chief confessed that when he used to wake up and go to work in the morning, he didn't feel like he had oodles of control over the nation's $2.2 trillion health care bill.

Here at New America, we too know that campaign slogans won't solve the problems but frankly we're still encouraged to see so much conversation in a bipartisan space about even these first steps. They won't reap enormous savings overnight, but we still believe that they can help put our health care system on a new and more sensible path—cost savings in a way that also improves quality. We didn't create a $2 trillion problem overnight, and we can't fix it overnight. But we're eager to get started.