In a response to GOP claims that health reform was only projected to reduce the deficit because of budget gimmicks, OMB Director Peter Orszag and Office of Health Reform chief Nancy-Ann DeParle have authored an op-ed in Friday's Washington Post.
The Senate health care bill--which serves as a basis for President Obama's own proposal--was scored by the Congressional Budget Office as reducing the federal deficit, but Rep. Paul Ryan (R) disputed this at the president's health care summit. The op-ed is largely a response to Ryan's criticism.
One interesting paradigm forwarded in the op-ed, however, is health reform as an ongoing thing--that what Obama and Democrats want to pass isn't something that will be set in stone, per se, as how health care will work in America forever--but rather that it includes mechanisms for feedback and opportunities for correction: that reform is, in effect, a dynamic and living process--not one event:
That would mean forgoing reforms that would be building blocks for a feedback loop of reform and improvement in our health-care system. For example, by bundling payments and creating accountable care organizations, as well as by imposing penalties for unnecessary re-admissions and health-facility-acquired infections, physicians and hospitals will be induced to redesign their systems, coordinate care to keep people healthy and avoid unnecessary complications.
Moreover, since health care is so dynamic, even if we thought we had the answer for containing costs and improving quality today, that would quickly change as health care evolved. With the additions of investments in health information technology, research into what works and what doesn't, and an Independent Payment Advisory Board of doctors and other medical experts making recommendations to improve the Medicare system, the legislation under consideration would create a virtuous circle in which more information becomes available, different delivery system reforms are tested and successful reforms are scaled up quickly as we learn more.