Map of life expectancy at birth from Global Education Project.

Monday, November 25, 2013

The ruling narrative vs.the truth

Usually a huge disconnect there, whatever the subject. Let's consider the Affordable Care Act, shall we? You know,the trainwreck that has cost Barack Obama the trust and affection of the American people?

You might consider this a bit of self-pleading; it's from the president's Council of Economic Advisers. But hey, reporters are supposed to pay attention to them as well as to Republican senators, right? The sustainability picture for health care really is improving.

Health care cost inflation is the lowest in 50 years. The CBO has reduced its forecast of Medicare and Medicaid costs in 2020 by 10%. And a lot of this has to do with the ACA - not the part everybody talks about, where most people have insurance. That hasn't even happened yet. But the ACA changed the way Medicare pays hospitals and reimburses providers -- you know, those "cuts" the Republicans used to scare elderly voters into putting the current crop of wingnuts in Congress. That doesn't hurt beneficiaries at all -- in fact it helps them. For one thing, hospitals have an incentive to keep people healthy and at home, instead of getting paid for failure when people have to be readmitted.

The slowdown in health care cost growth is more than just an artifact of the 2007-2009 recession: something has changed. The fact that the health cost slowdown has persisted so long even as the economy is recovering , the fact that it is reflected in health care prices – not just utilization or coverage, and the fact that it has also shown up in Medicare – which is more insulated from economic trends, all imply that the current slowdown is the result of more than just the recession and its aftermath. Rather, the slowdown appears to reflect “structural” changes in the United States health care system, a conclusion consistent with a substantial body of recent research.
• The ACA is contributing to the recent slow growth in health care price and spending and is improving quality of care. ACA provisions that reduce Medicare overpayments to private insurers and medical providers are contributing to the recent slow growth in health care prices and spending In addition, ACA reforms that aim to improve the quality of care are reducing hospital readmission rates and increasing provider participation in payment models designed to promote high-quality, integrated care.

This whole story is being completely ignored, not only by the corporate media, but by Democratic politicians who should be explaining this to the people and engaging in a full throated defense of the achievements of health care reform. Why isn't that happening?

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