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Tuesday, February 17, 2009

On Offer They Couldn’t Refuse?

On Monday, May 11, representatives of five national organizations representing providers of health care went to the White House and declared their intention to implement measures that would result in savings of $2 trillion over the next ten years. The declaration was announced by President Obama in front of the television cameras with representatives of the organizations lined up behind him.

The organizations making the declaration represented doctors, hospitals, pharmaceutical companies, health insurance companies, and organized labor.

It would be hard to overstate the significance of that event as a step along the way to reform of health care. Up until now, almost all of the public discussion of health care reform has focused on the uninsured and universal coverage. Little attention has been paid to the high and rising cost of care.

Now, for the first time, a national political leader in the person of President Obama is pointing out that the first priority of health care reform is to get cost under control, the implication being that unless we do that, we can’t afford to address the coverage issue.

In his remarks, the President has mentioned some cost control measures like prevention and information technology. However, the May 11 event indicates his understanding that in the end it is the providers of health care that have to do it.

Of course, the providers don’t want to do it. Lower cost means less income for them, not exactly something to which they look forward with joy.

There were no smiles on the faces of the people standing behind the President during his announcements. Somebody had made them an offer they couldn’t refuse. My own suspicion is that they were given to understand that their only hope of preventing the government from going into the health insurance business was to get serious about cost control.

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