In today’s Washington Post, Robert Samuelson writes:

“For decades, Americans have treated health care as if it exists in a separate economic and political world: When people need care, they should get it; costs should remain out of sight. About 60 percent of Americans receive insurance through their employers; to most workers, the full costs are unknown. The 65-and-older population and many poor people receive government insurance. Except for modest Medicare premiums and payroll taxes, costs are largely buried in federal and state budgets. It is this segregation of health care from everything else that is now crumbling — and the various health proposals are just one sign.” 

Understanding of what drives U.S. health care costs is fraught with myths. One such myth is that the uninsured are heavy users of expensive emergency room care, Samuelson notes. Gaining greater clarity in exposing costs and value of health care treatments is at the heart of a new approach [2 week free access] published yesterday in Health Affairs by Harvard professor Michael Chernew and Allison Rosen and Mark Fendrick of the University of Michigan. The aim of this “value-based insurance design” is to “help patients spend their health dollar wisely.” 

CQ HealthBeat’s John Reichard writes about the plan:

“One of the premises behind the emerging trend toward “consumer-driven health care” is that overall health costs won’t rise as quickly if patients are prodded to shop for better value by requiring them to pay a significant share of their medical expenses. But what if the way benefits are designed fails to steer them to the products and services that offer the best value? Fixing that problem is the key that will help unlock the savings potential of consumer-driven health care.”

Chernew and colleagues are briefing policymakers on Capitol Hill, specifically the House Energy and Commerce and Ways and Means committees. Will controlling and clarifying health care costs emerge as a key goal for health reformers? The debate over reform goals is alive on the blogs.