The health reform debate would be a lot simpler if the kind of center-of-center politicians inclined to worry about spending too much money were also inclined to support the kind of government intervention into the health care system that’s likely to reduce health care costs. But instead, the left finds itself needing to argue both sides of the issue against forces of the status quo who both object to the cost of giving people health care and object to cost-saving measures like a robust public plan. And the House Blue Dog Caucus is no exception judging by their latest letter on health reform. As Igor Volsky explains “the letter contains an inherent contradiction”
[T]he Blue Dogs want to find more savings within the system — they’re asking for Delivery System Reforms and “maximizing the value of our health care dollar” — but they’re also asking the bill to spend more on rural health and physician reimbursement. And, they are reluctant to support any legislation that moves us towards that goal, causes providers to lose revenue or regulates the system to improve efficiency.
Consider their objection to a “Medicare-like” public option that reimburses providers 5 to 10 percent above Medicare rates. According to MedPAC, Medicare rates are adequate and consistent with the efficient delivery of services. In fact, over-payments by private insurers to health-care providers drives up overall costs. “Hospitals which didn’t rely on high payment rates from private insurers ‘are able, in fact, to control their costs and reduce their costs when they need to’ and ‘combine low costs with quality,’” Glenn Hackbarth, the chairman of MedPAC, said during recent testimony in front of the House Ways and Means Committee. Moreover, if the public plan pays bloated market rates, it will fail to offer lower premiums within the Exchange, and would cause the government to spend more money on subsidies.
You don’t save money by magic. You save money by spending less money. You can do that by just letting a large and growing number of people go without adequate health care. Or else you can do that by spending less money on overpayments, inefficient processes, and unnecessary treatments. But you can’t do that without taking a bite out of someone’s bottom line. The Blue Dogs seem to be looking for a free lunch, or else just grasping at straws for reasons to object to the bill.
To her credit, I saw Lorretta Sanchez (D-CA) talking about this on MSNBC earlier. She’s a Blue Dog but she explained that she didn’t sign the letter specifically because she sees the public option that the letter objects to as a big part of the solution to the cost issues. That’s a correct and coherent stance, the rest of the caucus might want to listen to her.