No. of Recommendations: 4
Is there any incremental improvement you think could happen in our health care system, given the hard realities you describe? Any kind of legislation that might be helpful?
I mean, there's tons that "could" happen - but few of the politically possible measures involve reducing our health care expenditures to move us closer to what other countries do. It's politically difficult, but still possible, to increase what we spend on health care. That's what the ACA did. It expanded the amount of health care we provided, and increased the number of people receiving healthcare, primarily by the simple mechanism of having the government pay another $100B per year or so to pay for more people to get health care.
The simplest and easiest way to cut our spending a bit would be to have slight pressure on what government pays for health care services, such as Medicare and Medicaid reimbursement rates. Most of our health care spending, and the overwhelming majority of insured health care spending, is done in government programs. In 2023 (most recent data), total health care expenditures within insurance programs were about $3.6 trillion - of which about $2.1 trillion was government health insurance programs (including direct care like the VA), compared to only $1.4 trillion in private health insurance.
So if you wanted to reduce health care spending, start there. Just have the federal government decide that it's going to pay a little bit less to people to provide health care services under Medicare and Medicaid.
The problem, of course, is political. It's one thing to say in the abstract that you want the U.S. to pay less for health care than other countries do because it's unsustainable to pay 18% of GDP. But if you reduce the amount of money the government spends on health care, people will attack you for cutting health care spending.
