CBO director Peter Orszag talking about the problems with the current health care financing system says that “we need much more information about what works and what doesn’t.” With that in hand, we need to “pay for the stuff that works” as opposed to the system where “right now we have financial incentives for more care rather than better care.” To a large extent, our current system doesn’t deliver quality care because it’s not designed to elicit quality care, “we should align [financial] incentives so that we are seeking better care, then that’s what we’ll get.” Long story short, you need to pay health care providers for helping people rather than for treating them irrespective of efficacy.
On public health more broadly, he says “we need to be doing a lot more to help people lead healthy lives” which means we ought to “dial down a little bit the excessive reliance on narrow financial incentives to influence behavior” and pay more attention to the extensive psychological and sociological research on why it is people do things that aren’t in their long-term health interests and what we could do to push them in a healthier direction. Also this interesting fact — “we are experiencing a dramatic increase in life expectancy inequality in the United States . . . at the bottom of the socioeconomic distribution, life expectancy is either flat or declining . . . a lot of that has to do with health behavior.”