The aspect of health care policy that never really got the attention it deserves is what can we do to actually make the delivery of health care services more effective at a ground level. Like for example, maybe we shouldn’t have hospitals killing so many people with easily fixed errors. Mariah Blake just published a blockbuster piece about corrupt dealings in the organizations hospitals use to purchase medical equipment that’s also relevant to this conversation.
The Affordable Care Act contains a large number of provisions intended to make modest progress on these delivery system issues. Unfortunately, that largely ended up caught in a slightly pointless conversation about whether or not it was appropriate for the CBO to assume that all that stuff would have no impact on overall health care costs. The more important point, I think, is that whether or not improved productivity in the health care sector leads to reduced costs, it would be good news. Either we could get more health care for a fixed quantity of money, or else we could get an equal amount of health care but for less money, thus letting us buy more other stuff.
Way back in the fall of 2008, some of my colleagues at CAP put out a whole book on delivery system reform if you’re interested.