Wednesday, February 25, 2009

Costs, health care and the economy, Obama strategies - Response to WSJ Blog on Obama Strategy on Containing Health Costs

February 25, 2009
WSJ Health Blog

Obama Addresses Health Reform as a Cost Issue

Posted by Jacob Goldstein

During the campaign, Barack Obama’s health-reform agenda focused mainly on giving Americans access to care. In his first formal address to Congress last night, President Obama brought up health care again — but he framed it largely as an issue central to the economic health of the nation.

He led into the health-care section of his speech with the line, “[W]e must also address the crushing cost of health care.”

Then, after rattling off some numbers about rising health expenses and their impact on individual Americans, he said health-care costs are “one of the major reasons why small businesses close their doors and corporations ship jobs overseas” and “one of the largest and fastest-growing parts of our budget.”

“Given these facts,” he added, “we can no longer afford to put health care reform on hold.”

The speech was a prelude for Obama’s first budget, which will be released later this week. Early reports say there will be a substantial chunk of money in the budget for expanding access to health care.

There does seem to be a pretty strong political will for greater access; delivering the Republican response to Obama’s speech, Louisiana Gov. Bobby Jindal said: “Republicans believe in a simple principle: No American should have to worry about losing their health coverage.”

But, especially in the short term, the costs to the government of expanding access are likely to exceed any savings that come from finding ways to make care more efficient. And, if figuring out how best to expand access will be tough, figuring out how to lower costs — perhaps including reducing reimbursements to highly paid specialists, demanding lower prices on some expensive drugs and restricting the use of unproven treatments — will be even harder.


I enjoyed immensely Barack Obama’s beautiful, bereft of details, speech,

But simultaneously cutting costs and covering all exceeds mortal reach.

EMRs and comparative research to reduce costs has never been shown to work,

The Brits have tried, wasting five years and $18 billion, without on costs putting a cork,

Sorry, but between cutting costs and providing more care, there’s an unleapable breech.

Comment by Richard L. Reece, MD, -

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