(Updated at 3:50 pm with additional material.)
Let’s just get this out in the open: Jon Gruber has an agenda.
He really likes President Obama’s Patient Protection and Affordable Care Act. Heck, Gruber, the MIT economist, even wrote an entire comic book about the law (and served as an advisor to the president in developing the national plan). So, when he joins forces with Stuart Altman, professor of national health policy at Brandeis and John McDonough, director of the Harvard School of Public Health’s Center for Public Health Leadership to compare the “impacts of ObamaCare, RomneyCare, and RomneyCandidateCare on health care consumers in every state,” you’ve kind of got an idea of where they’re coming from.
Still, the comparison is useful in reinforcing their message with some numbers.
What the analysts found in comparing the president’s approach to candidate Romney’s “composite” set of health care proposals — which includes repealing the ACA — is this: ObamaCare is better all around because it helps more people gain access to health insurance and pay for their care.
As Gruber put it in a conference call with reporters today, ObamaCare and RomneyCandidateCare offer two “completely different” visions. “Rather than fixing the problem, RomneyCandidateCare will make things worse,” he said.
The full report is here. (Even the cover underscores the authors’ perspective with a photo of Obama next to two pictures of Romney, each facing a different direction. To me it screams “flip-flopper.” Am I alone here?)
Still, there is serious content inside. Continue reading
In an extensive, thoughtful new analysis in the journal Health Affairs, a troika of policy experts — Robert E. Mechanic, Stuart H. Altman and John E. McDonough — review Massachusetts’ new cost-containment law, including how we got there and the challenges that remain. For wonks, much of the material will be familiar, but it’s great to see it all laid out in one place, with sweeping, for-the-record breadth.
(For the truly hardcore, the entire September issue of Health Affairs
is devoted to payment reform. One highlight: Martha Bebinger’s excellent account
entitled, “Personal Responsibility: How Mitt Romney Embraced The Individual Mandate In Massachusetts Health Reform.”)
The lasting sense you get from this historical picture of health reform in the state is that while Mass. remains a national model when it comes to providing access to care and big thinking on policy, the delicate balance of upholding quality while scaling back cost is still being figured out. The authors conclude:
There are many uncertainties about Massachusetts’ efforts to slow health spending growth and the consequences if these efforts succeed or fail. For example, the potential impact on the state’s teaching and research institutions, which are more expensive than their community counterparts, is unclear. These institutions attract substantial federal and private medical research funding, provide high-quality care, and contribute to local economies through direct employment and related activity in the life sciences. Compelling them to direct their innovation and creativity toward the production of more efficient delivery models, and the elimination of waste should yield positive benefits. However, starving them into decline would be a severe loss for the state. Continue reading
If you missed Bill Clinton’s excellent, entertaining, arithmetic-laden and “muscular” sales pitch for Obama last night, here’s the full transcript from The Washington Post.
Also, read Ezra Klein’s smart analysis in which he concludes that the most important part of Clinton’s speech was the bit about Medicaid:
“…it’s arguably the most important and concrete policy difference between the two campaigns. The Medicare changes get more attention on both sides, but Romney and Ryan don’t intend to touch Medicare for 10 years, they swear they’ll honor the Medicare guarantee, and at least in Ryan’s most recent budget, he envisions the exact same long-term spending path as Obama does. By contrast, Romney and Ryan intend to begin cutting Medicaid immediately, and independent analyses suggest that their cuts could throw as many as 30 million people off the program. If you want to see the difference between Obama and Romney’s vision for American policy, it’s probably the single starkest example.
Which is, no doubt, why Clinton chose to highlight it. Tonight, his role was wonk-in-chief, and he was trying to persuade the public of an old idea: That the best way to understand this election is to simply do the arithmetic. And so, for 48 minutes, that’s pretty much what he did. The question now is whether the Romney campaign can persuade voters that there’s a mistake in Clinton’s math.”