In its first hearing of the year on healthcare reform, the House Energy and Commerce health subcommittee heard testimony that one of the key ways to improve the system without raising costs is to redirect the roughly $700 billion that is spent on services that do not improve patient health.
The crucial point that has been made by a number of speakers here today is that a large share of health spending does not seem to be improving health, said Doug Elmendorf, director of the Congressional Budget Office. We can reduce care that is not very useful and save money doing that. He said researchers have found no correlation between geographic areas that spend more on Medicare and positive health outcomes of their residents.
But Rep. Mike Rogers (R-Mich.) said that approach would appear to follow a model of rationing care, which many Americans oppose because it redistributes some care from the 85% of people who have health insurance to the 15% who currently do not.
To avoid rationing, Elmendorf said the key was to design new payment systems that can squeeze out the money that is not improving health and redirect it to programs and procedures with higher marks for quality. But such changes will need to rely on data from large-scale comparability studies. When were information-starved, as we are now, often the response is Do more. More is better, said Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission. Thats the refuge. We need to create a refuge so that more is not always the response to uncertainty.