No, really. The original goal -- remember? -- was not to give us a poor cousin of a single-payer system. It was to "bend the curve," as Paul Krugman points out. It was about "slowing the seemingly inexorable rise in health costs."
Now not so inexorable. In fact, Obamacare is doing its job very nicely. No, we're not finding a way of killing off the poor. Instead, we're looking at cost control that works.
Much of the Beltway establishment scoffed at the promise of cost savings. The prevalent attitude in Washington is that reform isn’t real unless the little people suffer; serious savings are supposed to come from things like raising the Medicare age (which the Congressional Budget Office recently concluded would, in fact, hardly save any money) and throwing millions of Americans off Medicaid. True, a 2011 letter signed by hundreds of health and labor economists pointed out that “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending.” But such expert views were largely ignored.
So, how’s it going? The health exchanges are off to a famously rocky start, but many, though by no means all, of the cost-control measures have already kicked in. Has the curve been bent?
The answer, amazingly, is yes. In fact, the slowdown in health costs has been dramatic. ...NYT
Caveat: We've seen fluctuations before. Costs were down during the Clinton years; costs went up during the W administrations. But for now it's clear that, for example, savings in Medicare have contributed to a lowering of overall costs -- and that affects the whole system.
Unless Congress refuses to do its job ...
The Independent Payment Advisory Board, a panel with the power to impose cost-saving measures (subject to Congressional overrides) if Medicare spending grows above target, hasn’t yet been established, in part because of the near-certainty that any appointments to the board would be filibustered by Republicans yelling about “death panels.” Now that the filibuster has been reformed, the board can come into being.
The news on health costs is, in short, remarkably good. You won’t hear much about this good news until and unless the Obamacare website gets fixed. But under the surface, health reform is starting to look like a bigger success than even its most ardent advocates expected ...NYT
