Paying for Outcomes

John McDonough

First published 5/9/11 on Kaiser Health News

Norbert Goldfield
Richard Averill

When it comes to reducing or controlling rising health care costs, we face a problem called “the fierce urgency of NOW.”

We have learned from the Medicare and Medicaid budget proposals by Rep. Paul Ryan, R-Wis., that Republicans have no substantive ideas on how to address these costs beyond shifting the bill to consumers and states. We also know that Democrats embedded a lot of promising ideas to generate savings into the health law — concepts ranging from medical homes and accountable care organizations to payment bundling and value-based insurance design. But these ideas will take time before we know if and how well they work.

But time is something we don’t have.

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The CBO Is Telling Us Something. Is Anybody Listening?


Originally published 1/11/11 on Kaiser Health News

The Congressional Budget Office’s budgetary scoring of the health reform law has returned as a subject of debate. At issue is whether health reform will really reduce the deficit by $143 billion through 2019 as the CBO predicted last year. It’s a legitimate question, but focusing on it misses the most important message conveyed by CBO estimates

Republicans in the House, who are intent to repeal the new health law, contend that eliminating it wouldn’t really increase the deficit. It’s an argument that makes sense if one is willing to reject the CBO’s deficit-reducing score of the law, and many are. There are good reasons to be skeptical that the law will in fact reduce the deficit.

Continue reading “The CBO Is Telling Us Something. Is Anybody Listening?”