Comments on: Where Is Health Spending Headed? Some Reactions To The CMS Report http://healthaffairs.org/blog/2013/01/31/where-is-health-spending-headed-some-reactions-to-the-cms-report/?utm_source=rss&utm_medium=rss&utm_campaign=where-is-health-spending-headed-some-reactions-to-the-cms-report The Policy Journal of the Health Sphere Sat, 15 Jun 2013 02:04:01 +0000 hourly 1 By: Brian Klepper http://healthaffairs.org/blog/2013/01/31/where-is-health-spending-headed-some-reactions-to-the-cms-report/comment-page-1/#comment-260096 Brian Klepper Fri, 01 Feb 2013 16:14:09 +0000 http://healthaffairs.org/blog/?p=27674#comment-260096 An excellent and important analysis that should, but won’t, give every health care executive pause, because it describes a path to inevitable collapse as health care prices itself out of its own market. And because health care is the largest economic sector, it also describes a path that will pull the larger US economy off a cliff. But so far, nobody’s really interested.

Clearly, the industry won’t change on its own. The horse’s mouth here is Florida Governor and former HCA CEO Rick Scott, who opined, “How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system.”

We’re unlikely to get real change through policy either, because the industry has effectively captured the regulatory process. The industry contributed $1.2 billion in Congressional campaign contributions in 2009 to influence the shape of the law. And it has enormous leverage in other mechanisms, like the AMA’s RVS Update Committee. In the most recent legal challenge to the RUC, the district and appeals courts ruled that they have no jurisdiction. So the RUC is beyond the reach of the law and therefore utterly unaccountable. Only our Congressional representatives can remedy that, and they’re on the industry’s payroll.

The industry’s hIgh fragmentation, along with a uniform dedication to optimizing short term margins, is a recipe for a bursting bubble. Because health care is so tied to people’s welfare, the ramifications could be horrific.

There is little likelihood of a workable solution. Our inability to establish purchasers – the one group that’s bigger and more influential than the health industry – as a counterweight to the health industry’s institutionalized rapaciousness is our most frightening national weakness at present.

]]> By: James L. McGee http://healthaffairs.org/blog/2013/01/31/where-is-health-spending-headed-some-reactions-to-the-cms-report/comment-page-1/#comment-260088 James L. McGee Fri, 01 Feb 2013 15:52:34 +0000 http://healthaffairs.org/blog/?p=27674#comment-260088 These are Helpful insights. thank you.
Just some thoughts / questions on the rise in per beneficiary Medicare spending. Both related to the increasing number of insured.
The first is a bit cynical. Could the rise be caused by physicians who are seeing a reduction in the number of their insured patients and are then finding ways to deliver more services to their Medicare patients?
Another possibility is that Medicare is seeing a growing number of new enrollees who were previously uninsured and are now catching up on services and care they previously did not have access to?

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