Some good back and forth on health-care reform with and without a public option or a Medicare buy-in by Nate Silver. 20 Questions, 20 Responses
I’m happy that this debate seems to be evolving into something a little more civilized on all sides. This is my response to Markos Moulitsas (DK) at Daily Kos and Jon Walker (JW) at FireDogLake who were kind enough to respond to the 20 questions I posed earlier.
Nate is of the side that thinks there are quite a few benefits, real and political, to accepting the health-care reform package without the public option. Kos and Firedoglake are not so inclined. There are lots of comments on the post. Some of them smack of concern trolling, but those aside many good points are made. Ezra Klien looks at the cost controls in the package sans the public option, Five cost controls in the Senate health-care bill
1) Bundled payments: A lot of the focus has been on cost controls that work through the insurance system. But costs aren’t rising because insurance is expensive. They’re rising because health care is expensive. The experiments with bundled payments are an attempt to begin addressing those drivers directly. Right now, hospitals get paid for each procedure they conduct. If you come in with symptoms of a stroke, they get one check for the diagnostic, one check for the stroke medication, one check for the surgery, etc. And if you have to come back in two weeks, they get more money for that, too.
Under bundled payments, the hospital would receive one check for everything related to your stroke over a single period of time. That means they make more money from doing less, rather than more money from doing more. It also gives them an incentive to coordinate care when you’re out of the hospital…
Again, some of the comments are worth reading.