CALPIRG Blog

It's been a busy few weeks in the health care world: President Obama's held a health care summit and is planning regional forums throughout the country, key Congressional leaders are fleshing out legislation, and supporters and opponents of reform have stepped up their jockeying for position. 

But one of the most interesting things that's happened in the last week is an interview with former President Clinton -- who also worked on health care reform, fifteen years ago.

In the interview, he says "I don't want us to wind up getting universal coverage, which is morally imperative and necessary, and not do enough preventative and primary and cost control changes about the way the system is organized to bring our costs in line... the challenge is going to be not the coverage challenge, which is what all of us from Theodore Roosevelt through Bill Clinton faced.  It's going to be the cost challenge."

The President's right.  Covering everybody is a critical component of reform.  But for it to be sustainable, it's absolutely imperative that we make the investments in cost containment needed to make the system affordable. 

In fact, this is where the fight is going to be the hardest.  The big insurers and drug companies are OK with expanding coverage -- it means more customers for them.  But changing the rules of the road so that patients are getting more health care bang for their buck?  That threatens their bottom line. If the special interests had their way, everybody would have coverage -- and would bankrupt themselves trying to pay for it.

Fortunately, President Obama is listening to his predecessor.  His plan not only aims for universality -- it also takes on the special interests by taking strong steps to get costs under control.

Obama is calling for research on which treatments, drugs, and devices work best. By getting this information to doctors, they’ll be able to develop evidence-based practices that are effective at keeping people healthy. 

It will also help lower costs by reducing the use of ineffective treatments that provide no real benefit to patients – estimates are that these kinds of wasteful treatments are responsible for a third of health care spending.

He's also working to prioritize prevention and primary care, rather than overpaying specialists to deal with crises once patients are sick. The key is to change the way doctors are paid, to create incentives for the kind of coordinated care and counseling that keep patients well and avoid costly emergency room visits.

These policies don't seem as immediately profound as getting coverage for every American.  But this is where the special interests are going to fight their hardest, hoping to keep things out of the public eye.  And as both Presidents have said, it's critical to get these pieces right to keep health care affordable.