Former Minnesota governor and potential presidential candidate Tim Pawlenty (R) thought he was laying out a conservative vision of government and health reform during his speech at the National Press Club today, but he inadvertently made the case for the Affordable Care Act, which he would like to repeal. Watch it:
Let’s go through his claims one by one:
1) CLAIM 1– MORE TRANSPARENCY/KNOWLEDGE NEEDED: “If you have a system where people get to consume things without knowledge and responsibility about making wise choices about price and quality and the provider has no incentive other than to provide more volume of whatever is being consumed or given and the myth is the bill goes somewhere else and that it is all free, that is a system that I assure you is doomed to fail. That unfortunately is most of government, it is particularly most of health care system.”
FACT 1 — The new HealthCare.gov, which is probably the most successful element of the law thus far, allows families and individuals to compare plans in their geographic areas bases on price, quality, benefits — that’s the “knowledge” part. By 2014, consumers will enter more organized state-based exchanges — or new insurance marketplaces — where insures will have to offer a standard benefits package that are even easier to compare. Here comes “responsibility”: Americans will have to purchase an insurance policy to ensure that the bill does not “go somewhere else” or is shifted throughout the system. That pretty much busts the “myth” that “it is all free.”
2) CLAIM 2 — HEALTH COSTS ARE OUT OF CONTROL: “If you look at what’s driving much of government spending for cities, for school districts, for counties, for states, for the federal government, it is indeed the health care issues. It is driving budgets at a pace that exceeds almost everything else. And if we don’t solve this problem, really solve this problem, it will take down the country or at least impair it from within.”
FACT 2 — Health care costs are increasing government spending and the Affordable Care Act will slow the rate of growth for health spending. A September report from the Center for Medicare & Medicaid Services (CMS) found that while the government will spend more on care during the initial period of coverage expansion, once the cost savings and efficiencies kick in, costs will “decelerate.” Moreover, the actuaries predicted that as a result of these savings, Medicare spending will decline $86.4 billion from previous projections due to reforms. “Specifically, average annual Medicare spending growth is anticipated to be 1.4 percentage points slower for 2012–19 than we projected in February 2010. By 2019, it is projected to grow 7.7 percent—0.9 percentage point more slowly than we projected in February 2010,” the report concluded.
3) CLAIM 3 — PROVIDERS HELD ACCOUNTABLE FOR RESULTS: “We need to have systems where consumers, or at least purchasers are in charge. They have user-friendly information about price and quality. That the providers of the service have incentive to do more than just provide volume. That they have to be held accountable for better results and better health and that the money is in alignment in those goals.”
FACT 3 — For an example of “user-friendly” information click over to HealthCare.gov and see Fact 1. The law also addresses the complaint that our health care system rewards quantity over quality by establishing demonstration projects that experiment with different ways of paying providers so that they don’t have an incentive to over-prescribe services or medications. Specifically, it allows providers organized as accountable care organizations (ACOs) that voluntarily meet quality thresholds to share in the cost savings they achieve for the Medicare program and has created an Innovation Center to test, evaluate, and expand in Medicare, Medicaid, and CHIP different payment structures and methodologies to reduce program expenditures while maintaining or improving quality of care.
Pawlenty may wish to tweak some of these provisions to reflect his more conservative ideology, but he wants you to believe that reform doesn’t begin to address any of these concerns and instead gives everyone a free ride on the government’s dime.

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