As the debate over health reform becomes more and more focused on issues of “health care cost containment,” Mark Blumenthal at Pollster.com raises a crucial and much-ignored question: whose costs are we talking about here?
When Americans tell pollsters they want health care reform to focus on “costs” they usually mean their actual, out-of-pocket health care expenses: insurance premiums, deductibles, co-pays, the costs of prescription drugs and any other medical bills not covered by health insurance.
That’s not the same, of course, as what CBO or health policy wonks mean by “costs,” which is typically either the federal government’s outlays or the overall rate of inflation in the health care sector.
Blumenthal also notes that a rare poll focused on the kind of cost containment regular folks want shows some pretty amazing levels of support from Ds and Rs alike:
The survey…sponsored by the labor-business coalition known as America’s Agenda, included a test of measures to “reduce costs” that speaks directly to these kinds of out-of-pocket expenses:
Now I would like to read you a proposal that is being considered to reform health care. This proposal aims to reduce costs and improve quality of health care in the following ways: make health coverage more affordable and accessible for all Americans; eliminate co-pays and deductibles for recommended chronic disease treatment prescribed by your doctor; eliminate co- pays and deductibles for recommended preventive services and emphasize disease prevention including reducing obesity and smoking; ensure that doctors have accurate and updated information on the most effective treatments; and ensure that patients receive highly-coordinated, personalized treatment plans based on the latest medical evidence.
While the America’s Agenda poll did not test this proposal against alternatives, I would not be surprised to see Americans with health insurance react more positively to it than anything else we could dream up, especially if the alternative is framed in terms of providing “access” to those presently uninsured (in other words, to somebody else).
All these elements–particularly an emphasis on prevention, chronic disease management, electronic medical records, and research on effective treatments–have been part of what Barack Obama has meant by “cost containment” in the past, even if they haven’t much appeared in congressional plans. Looks like it would be a very good time for Obama to shift attention back to these highly popular forms of cost containment right now.